scholarly journals Successful COVID-19 rescue therapy by extra-corporeal membrane oxygenation (ECMO) for respiratory failure: a case report.

2020 ◽  
Author(s):  
Michael S Firstenberg ◽  
Philip F. Stahel ◽  
Jennifer Hanna ◽  
Chakradhar Kotaru ◽  
Joseph Crossno ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Rescue Therapy ◽  
Antiviral Treatment ◽  
Positive Outcome ◽  
Inhalation Therapy ◽  
Team Approach ◽  
Compassionate Use ◽  
Her Family ◽  
Membrane Oxygenation

Abstract Background: The value of extracorporeal membrane oxygenation (ECMO) for patients suffering from novel coronavirus disease 2019 (COVID-19) as a rescue therapy for respiratory failure remains controversial and associated with high mortality rates of 50% to 82% in early reports from Wuhan, China. We hypothesized that patient outcomes would be improved at our tertiary cardiothoracic surgery referral center with a protocolized team-approach for ECMO treatment of patients with severe COVID-19 disease. Case Presentation: A 51-year-old healthy female developed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) bilateral pneumonia while vacationing in Colorado with her family. She was transferred to our facility for a higher level of care. Her respiratory status continued to deteriorate despite maximized critical care, including prone positioning ventilation and nitric oxide inhalation therapy. Veno-venous ECMO was initiated on hospital day 7 in conjunction with a 10-day course of compassionate use antiviral treatment with remdesivir. The patient’s condition improved significantly and she was decannulated from ECMO on hospital day 17 (ECMO day 11). She was successfully extubated and eventually discharged to rehabilitation on hospital day 28.Conclusion: This case report demonstrates that the judicious application of ECMO for respiratory failure due to SARS-CoV-2 pneumonia in conjunction with compassionate use antiviral treatment (remdesivir) resulted in a positive outcome in a young patient with a high predicted mortality from COVID-19. Future prospective multi-center studies are needed to validate these findings in a larger cohort of patients.

scholarly journals Successful COVID-19 rescue therapy by extra-corporeal membrane oxygenation (ECMO) for respiratory failure: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Michael S. Firstenberg ◽  
Philip F. Stahel ◽  
Jennifer Hanna ◽  
Chakradhar Kotaru ◽  
Joseph Crossno ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Rescue Therapy ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation

scholarly journals Extracorporeal membrane oxygenation as rescue therapy for severe hypoxemic respiratory failure

2019 ◽  
Vol 11 (S14) ◽  
pp. S1688-S1697 ◽  
Author(s):  
Bhoumesh Patel ◽  
Subhasis Chatterjee ◽  
Seanna Davignon ◽  
J. Patrick Herlihy
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Rescue Therapy ◽  
Hypoxemic Respiratory Failure ◽  
Membrane Oxygenation

The Evaluation of Extracorporeal Membrane Oxygenation in Children with Acute Hypoxemic Respiratory Failure in China: A Five-year Single-center Retrospective Study

2021 ◽  
Author(s):  
Jiayun Ying ◽  
Ye Cheng ◽  
Gangfeng Yan ◽  
Guoping Lu ◽  
Weiming Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Rescue Therapy ◽  
Vital Signs ◽  
Data Entry ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Laboratory Findings ◽  
Membrane Oxygenation

Abstract Objective: To summarize the clinical features, laboratory parameters, and outcomes of children with acute hypoxemic respiratory failure supported by extracorporeal membrane oxygenation and explore the risk factors of the prognosis.Methods: It’s a retrospective study from one hospital the Pediatric Intensive Care Unit of Children’s Hospital of Fudan University in China. Patients, aged 28 days to 18 years, with acute hypoxemic respiratory failure supported by mechanical ventilation underwent extracorporeal membrane oxygenation from January 2015 to December 2019 were enrolled in this study. The primary outcome was defined as in-hospital mortality within 28 d after admission. Demographics, medical history, comorbidities, laboratory findings, vital signs, medications, need for continuous renal replacement therapy, need for other rescue therapy, need for transportation, ventilator settings, oxygenation indices were recoded. Appropriate data entry and statistical analysis were performed on access 2007 and SPSS software version 23.Results: Fifty patients with severe acute hypoxemic respiratory failure were enrolled in the study. We analyzed 45 patients (90%) after excluding 5 for missing data. Overall mortality was 53.5%. The PaO2 prior to extracorporeal membrane oxygenation was higher (64 cmH2O [51.9, 70.0 cmH2O] vs 55.1 cmH2O [43.8,60.1], p = 0.009) and OI prior to extracorporeal membrane oxygenation was lower (33.3 [30.1, 40.7] vs 41.2 [33.2 -55.1], p = 0.031) in survivors than nonsurvivors. In multivariate analysis, PaO2 prior to extracorporeal membrane oxygenation was significantly associated with survival (odds ratio 1.129, 95% Cl 1.022 -1.247).Conclusions: Extracorporeal membrane oxygenation might be an alternative strategy for pediatric patients with severe acute hypoxemic respiratory failure Low PaO2 prior to extracorporeal membrane oxygenation indicated a poor prognosis. Maybe we should consider that extracorporeal membrane oxygenation should be implemented earlier.Trial registration: This study was registered on the Clinical Trail. The number is NCT04709432.

scholarly journals Case Report: Prolonged VV-ECMO (111 Days) Support in a Patient With Severe COVID-19

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhiheng Xu ◽  
Yonghao Xu ◽  
Dongdong Liu ◽  
Xuesong Liu ◽  
Liang Zhou ◽  
...  
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Extracorporeal Membrane Oxygenation ◽  
Supportive Care ◽  
High Mortality ◽  
Rescue Therapy ◽  
Membrane Oxygenation ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Vv Ecmo

Venovenous extracorporeal membrane oxygenation (VV-ECMO) may be a lifesaving rescue therapy for patients with severe coronavirus disease 2019 (COVID-19). However, little is known regarding the efficacy of prolonged ECMO (duration longer than 14 days) in patients with COVID-19. In this case report, we report the successful use of prolonged VV-ECMO (111 days) in a 61-year-old man with severe COVID-19. Given the high mortality rate of severe COVID-19, this case provided evidence for use of prolonged VV-ECMO as supportive care in patients with severe COVID-19.

scholarly journals Evaluation of Extra Corporeal Membrane Oxygenation Support in Adult Cardio Respiratory Failure-An Observational Study.

2019 ◽  
pp. 1-10
Keyword(s):  
Respiratory Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Rescue Therapy ◽  
Adult Population ◽  
Vascular Complications ◽  
Limb Ischemia ◽  
Ecmo Support ◽  
Membrane Oxygenation ◽  
Patient Stay

Abstract Extracorporeal life support is a rescue therapy when mechanical ventilation is unable to maintain adequate tissue oxygenation in the setting of acute cardiac or respiratory failure. Outcome is influenced not only by factors independent of ECMO but also by the potential complications related to ECMO. The study is designed to understand the outcomes of Extracorporeal membrane oxygenation in the management of Acute Cardio Respiratory failure in adult population. The study is analytical and the data is prospectively collected from a local registry of ECMO patients and ICU clinical database. Further, clinical details were obtained from prospective review of patient medical records. The study period is from November 2013 and November 2015. A total of 30 patients were included in the study 36.7% were weaned off ECLS and 33.3% survived to hospital discharge. Incidence of Heparin Induced Thrombocytopenia was observed in 3 patients. 27 patients went into renal dysfunction. Both ICU duration (p-0.945) and duration of ECMO (0.736) support did not prove to be significant in predicting mortality. No cannula related vascular complications leading to limb ischemia or need for vascular repair were encountered in any patient. Mean number of blood transfusions required during ECMO support were 15.17 units. Infections acquired on ECMO support, p=0.052; 95% CI=0.007-1.707. Our results endorse the use of ECMO as a rescue therapy in adults, although there are some risks associated with a learning curve as well as an important increase in the days of patient stay. However, ECMO is still marred by frequent and significant complications such as renal derangement, bleeding and nosocomial infections.

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