scholarly journals Extracorporeal Membrane Oxygenation Retrieval in Coronavirus Disease 2019: A Case-Series of 19 Patients Supported at a High-Volume Extracorporeal Membrane Oxygenation Center

2020 ◽  
Vol 2 (10) ◽  
pp. e0228 ◽  
Author(s):  
Jordi Riera ◽  
Eduard Argudo ◽  
María Martínez-Martínez ◽  
Sandra García ◽  
Marina García-de-Acilu ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
High Volume ◽  
Membrane Oxygenation

scholarly journals Veno-venous extracorporeal membrane oxygenation in coronavirus disease 2019: a case series

2020 ◽  
Vol 6 (4) ◽  
pp. 00463-2020
Author(s):  
Joe Zhang ◽  
Blair Merrick ◽  
Genex L. Correa ◽  
Luigi Camporota ◽  
Andrew Retter ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
High Volume ◽  
Patient Characteristics ◽  
Interquartile Range ◽  
Membrane Oxygenation ◽  
Intravascular Thrombosis ◽  
The Uk ◽  
High Degree ◽  
Vv Ecmo

BackgroundThe use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in severe hypoxaemic respiratory failure from coronavirus disease 2019 (COVID-19) has been described, but reported utilisation and outcomes are variable, and detailed information on patient characteristics is lacking. We aim to report clinical characteristics, management and outcomes of COVID-19 patients requiring VV-ECMO, admitted over 2 months to a high-volume centre in the UK.MethodsPatient information, including baseline characteristics and clinical parameters, was collected retrospectively from electronic health records for COVID-19 VV-ECMO admissions between 3 March and 2 May 2020. Clinical management is described. Data are reported for survivors and nonsurvivors.ResultsWe describe 43 consecutive patients with COVID-19 who received VV-ECMO. Median age was 46 years (interquartile range 35.5–52.5) and 76.7% were male. Median time from symptom onset to VV-ECMO was 14 days (interquartile range 11–17.5). All patients underwent computed tomography imaging, revealing extensive pulmonary consolidation in 95.3%, and pulmonary embolus in 27.9%. Overall, 79.1% received immunomodulation with methylprednisolone for persistent maladaptive hyperinflammatory state. Vasopressors were used in 86%, and 44.2% received renal replacement therapy. Median duration on VV-ECMO was 13 days (interquartile range 8–20). 14 patients died (32.6%) and 29 survived (67.4%) to hospital discharge. Nonsurvivors had significantly higher d-dimer (38.2 versus 9.5 mg·L−1, fibrinogen equivalent units; p=0.035) and creatinine (169 versus 73 μmol·L−1; p=0.022) at commencement of VV-ECMO.ConclusionsOur data support the use of VV-ECMO in selected COVID-19 patients. The cohort was characterised by high degree of alveolar consolidation, systemic inflammation and intravascular thrombosis.

Psychiatric Outcome after Severe Cardio-Respiratory Failure Treated with Extracorporeal Membrane Oxygenation: A Case-Series

2013 ◽  
Vol 54 (5) ◽  
pp. 418-427 ◽  
Author(s):  
Ivar Risnes ◽  
Aasta Heldal ◽  
Kari Wagner ◽  
Birgitte Boye ◽  
Ira Haraldsen ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
Membrane Oxygenation ◽  
Psychiatric Outcome

Inter-Hospital Transport of Neonatal Patients on Extracorporeal Membrane Oxygenation: Mobile-ECMO

PEDIATRICS ◽  
1995 ◽  
Vol 95 (4) ◽  
pp. 562-566
Author(s):  
Mark J. Heulitt ◽  
Bonnie J. Taylor ◽  
Sherry C. Faulkner ◽  
Lorrie L. Baker ◽  
Carl W. Chipman ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
High Frequency Ventilation ◽  
Medical Patients ◽  
Retrospective Case ◽  
Membrane Oxygenation ◽  
Limited Series ◽  
Frequency Ventilation ◽  
Hospital Transport

Objective. To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. Design. This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series. Settings. The study was conducted at a regional referral children's hospital and ECMO unit. Patients. Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO. Results. Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up data were available on all nine survivors of neonatal mobile- ECMO. Eight of these had normal magnetic resonance imaging scans of the brain; the ninth had a small hemorrhage in the left cerebellum. Conclusion. Our limited series shows that patients can be safely transported with mobile-ECMO. This program does not replace the early appropriate transfer for ECMO-eligible patients to an ECMO center.

Curriculum to Introduce Critical Care Nurses to Extracorporeal Membrane Oxygenation

2020 ◽  
Vol 29 (4) ◽  
pp. 262-269
Author(s):  
Whitney D. Gannon ◽  
Lynne Craig ◽  
Lindsey Netzel ◽  
Carmen Mauldin ◽  
Ashley Troutt ◽  
...  
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Reference Group ◽  
High Volume ◽  
Critical Care Nurses ◽  
Care Nurse ◽  
Membrane Oxygenation ◽  
Written Examination ◽  
Advanced User ◽  
Before And After

Background Despite the growing use of extracorporeal membrane oxygenation (ECMO) in intensive care units (ICUs), no standardized ECMO training pathways are available for ECMO-naive critical care nurses. Objectives To evaluate a critical care nurse ECMO curriculum that may be reproducible across institutions. Methods An ECMO curriculum consisting of a basic safety course and an advanced user course was designed for critical care nurses. Courses incorporated didactic and simulation components, written knowledge examinations, and electronic modules. Differences in examination scores before and after each course for the overall cohort and for participants from each ICU type were analyzed with t tests or nonparametric equality-of-medians tests. Differences in postcourse scores across ICU types were examined with multiple linear regression. Results Critical care nurses new to ECMO (n = 301) from various ICU types participated in the basic safety course; 107 nurses also participated in the advanced user course. Examination scores improved after completion of both courses for overall cohorts (P < .001 in all analyses). Median (interquartile range) individual score improvements were 23.1% (15.4%-38.5%) for the basic safety course and 8.4% (0%-16.7%) for the advanced user course. Postcourse written examination scores stratified by ICU type, compared with the medical ICU/cardiovascular ICU group (reference group), differed only in the neurovascular ICU group for the basic safety course (percent score difference, −3.0; 95% CI, −5.3 to −0.8; P = .01). Conclusions Implementation of an ECMO curriculum for a high volume of critical care nurses is feasible and effective.

scholarly journals Neurologically Devastating Intraparenchymal Hemorrhage in COVID-19 Patients on Extracorporeal Membrane Oxygenation: A Case Series

Neurosurgery ◽  
2020 ◽  
Vol 87 (2) ◽  
pp. E147-E151 ◽  
Author(s):  
Sabrina M Heman-Ackah ◽  
YouRong Sophie Su ◽  
Michael Spadola ◽  
Dmitriy Petrov ◽  
H Isaac Chen ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Intracranial Hemorrhage ◽  
Case Reports ◽  
Case Series ◽  
Therapeutic Modality ◽  
Membrane Oxygenation ◽  
Resource Setting ◽  
Therapeutic Algorithms ◽  
Successful Recovery ◽  
Vv Ecmo

Abstract BACKGROUND AND IMPORTANCE Extracorporeal membrane oxygenation (ECMO) represents a life-saving therapy in cases of refractory hypoxia and has been utilized in patients suffering from the most severe forms of coronavirus disease 2019 (COVID-19). A strikingly high mortality rate of 94% was described in early reports of patients with COVID-19 transitioned to ECMO. Later case reports and series demonstrating successful recovery from COVID-19 after ECMO have revived interest in this therapeutic modality, including the recent approval of ECMO for COVID-19 patients by the Food and Drug Administration (FDA). Here, we present the first reports of devastating intracranial hemorrhage as a complication of veno-venous (VV) ECMO in two COVID-19 patients. CLINICAL PRESENTATION We performed a retrospective analysis of 2 cases of devastating intracranial hemorrhage in patients on VV-ECMO for the treatment of COVID-19. Collected data included clinical history, laboratory results, treatment, and review of all available imaging. Both patients demonstrated activated partial thromboplastin times (aPTT) within an appropriate therapeutic range. No risk factors that clearly predicted likelihood of this complication were identified. CONCLUSION Understanding the complications of ECMO in this cohort and developing therapeutic algorithms to aid in optimal patient selection will be critical in the limited resource setting experienced as a result of global pandemic. We propose the use of head computed tomography (CT) to identify devastating neurological complications as early as possible, aiding in the resource allocation of ECMO machines to the most appropriately selected patients.

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