Veno-venous Extracorporeal Membrane Oxygenation for Respiratory Failure in COVID-19 Patients: Early Experience From a Major Academic Medical Center in North America.

Annals of Surgery
Asishana A OshoMasaki Funamoto

Abstract

VV ECMO can be utilized as an advanced therapy in select patients with COVID-19 respiratory failure refractory to traditional critical care management and optimal mechanical ventilation. Anticipating a need for such therapies during the pandemic, our center created a targeted protocol for ECMO therapy in COVID-19 patients that allows us to provide this life-saving therapy to our sickest patients without overburdening already stretched resources or excessively exposing healthcare staff to infection risk. As a major regional referral program, we used the framework of our well-established ECMO service-line to outline specific team structures, modified patient eligibility criteria, cannulation strategies, and management protocols for the COVID-19 ECMO program. During the first month of the COVID-19 outbreak in Massachusetts, 6 patients were placed on VV ECMO for refractory hypoxemic respiratory failure. The median (interquartile range) age was 47 years (43-53) with most patients being male (83%) and obese (67%). All cannulations were performed at the bedside in the intensive care unit in patients who had undergone a trial of rescue therapies for acute respiratory distress syndrome including lung protective ventilation, paralysis, p...Continue Reading

References

Jan 14, 2018·Annals of Intensive Care·Mohammed S AlshahraniWaleed Alhazzani
Apr 4, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Xin LiJiapeng Huang
Apr 4, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Robert H BartlettMatthew L Paden

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