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 Successful management of severe acute respiratory distress syndrome due to COVID-19 with extracorporeal membrane oxygenation during mid-trimester of pregnancy

2021 ◽  
Vol 14 (2) ◽  
pp. e240823
Author(s):  
Zenab Yusuf Tambawala ◽  
Zeinabsadat Tabatabaei Hakim ◽  
Lama Khalid Hamza ◽  
Maryam Al Rayes
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Rescue Therapy ◽  
Good Condition ◽  
Nasopharyngeal Swab ◽  
Membrane Oxygenation ◽  
Surgical Icu ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Vv Ecmo

A 29-year-old pregnant woman presented at 26 weeks of gestation with fever and cough for 4 days. On admission, her nasopharyngeal swab confirmed COVID-19. As her respiratory distress worsened, she was shifted to the intensive care unit (ICU). Since the patient was unable to maintain saturation even on high settings of mechanical ventilation, she underwent venovenous extracorporeal membrane oxygenation (VV-ECMO) and was monitored in surgical ICU by a multidisciplinary team. The obstetrical team was on standby to perform urgent delivery if needed. Her condition improved, and she was weaned off after 5 days on extracorporeal membrane oxygenation. She was observed in the antenatal ward for another week and discharged home with the mother and fetus in good condition. VV-ECMO can be considered as rescue therapy for pregnant women with refractory hypoxaemia of severe respiratory failure due to COVID-19. It can save two lives, the mother and fetus.

Hybrid extracorporeal membrane oxygenation (ECMO) cannulation following traumatic pneumonectomy: A case report

Trauma ◽  
2022 ◽  
pp. 146040862110552
Author(s):  
Jay I Conhaim ◽  
Nick C Levinsky ◽  
Paige L Barger ◽  
Heather L Palomino
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Right Heart Failure ◽  
Flow Limitation ◽  
Right Heart ◽  
Membrane Oxygenation ◽  
Operative Complications ◽  
Potential Loss ◽  
Vv Ecmo

A 28-year-old man presented in extremis after a motorcycle crash. Following traumatic pneumonectomy, he developed right heart failure and was placed on veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) only to transition to veno-arteriovenous (VAV) ECMO due to persistent hypoxemia. Resulting flow limitation caused distal ischemia of his left leg, requiring thrombectomy and fasciotomy. Potential loss of limb necessitated transitioning to veno-venous (VV) ECMO from which he was successfully decannulated thereafter. ECMO can bridge recovery following the most dire injuries, and hybrid strategies can ameliorate post-operative complications; however, ECMO itself carries significant risks that must be weighed against intended benefit.

Bleomycin-induced lung injury treated with venovenous extracorporeal membrane oxygenation (ECMO) and ultra-protective ventilator settings

2020 ◽  
Vol 13 (11) ◽  
pp. e236474
Author(s):  
Mazen Faris Odish ◽  
William Cameron McGuire ◽  
Patricia Thistlethwaite ◽  
Laura E Crotty Alexander
Keyword(s):  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Case Reports ◽  
Rapid Onset ◽  
High Dose ◽  
Drug Induced ◽  
Membrane Oxygenation ◽  
Hypoxic Respiratory Failure ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Vv Ecmo

Bleomycin treats malignancies, such as germ cell tumours and Hodgkin lymphoma. While efficacious, it can cause severe drug-induced lung injury. We present a 42-year-old patient with stage IIB seminoma treated with radical orchiectomy followed by adjuvant chemotherapy with bleomycin, etoposide and cisplatin. His postbleomycin course was complicated by the rapid onset of hypoxic respiratory failure, progressing to acute respiratory distress syndrome and requiring venovenous extracorporeal membrane oxygenation (VV-ECMO) support. Although the patient was treated with high dose systemic steroids and ultra-protective ventilator strategies to minimise ventilator-induced lung injury while on VV-ECMO, his lung injury failed to improve. Care was withdrawn 29 days later. Lung autopsy revealed diffuse organising pneumonia. We found six case reports (including this one) of bleomycin-induced lung injury requiring VV-ECMO with a cumulative survival of 33% (2/6). While VV-ECMO may be used to bridge patients to recovery or lung transplant, the mortality is high.

Comparison of atrio-femoral and femoro-atrial venovenous extracorporeal membrane oxygenation in adult

Perfusion ◽  
2020 ◽  
pp. 026765912096902
Author(s):  
Steven Kin-ho Ling
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Case Control Study ◽  
Case Control ◽  
Single Centre ◽  
Retrospective Case ◽  
Membrane Oxygenation ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Control Study ◽  
Ecmo Flow ◽  
Vv Ecmo

Introduction: Different cannulation approaches existed for veno-venous extracorporeal membrane oxygenation (VV ECMO). We aimed to compare the atrio-femoral (AF) and femoro-atrial (FA) configuration in terms of their flow efficiency and influence on patient outcome. Method: This was a single-centre, retrospective case control study. Adult patients admitted to the Intensive Care Unit and required VV ECMO service at Tuen Mun Hospital, Hong Kong, from June 2015 to January 2020 were included. Data were collected from our ECMO database for comparison. Results: Between June 2015 and January 2020, eight patients received AF configuration and 19 patients received FA configuration. The maximum achieved flow in the AF group was significantly higher than that in the FA group (4.08 ± 0.57 L/min vs. 3.52 ± 0.58 L/min, p = 0.03). The fluid balance in first 3 days of ECMO was significantly lower in the AF group compared to that in the FA group (1.16 ± 2.71 L vs. 3.46 ± 1.97 L, p = 0.02). As well, the chance for successful awake ECMO was statistically higher in the AF group (p = 0.048). Conclusion: Atrio-femoral configuration in VV ECMO was associated with a higher maximum achieved ECMO flow, less fluid gain in first 3 days of ECMO and more successful awake ECMO.

A descriptive evaluation of causes of death in venovenous extracorporeal membrane oxygenation

Perfusion ◽  
2021 ◽  
pp. 026765912110359
Author(s):  
Sagar B Dave ◽  
Kristopher B Deatrick ◽  
Samuel M Galvagno ◽  
Michael A Mazzeffi ◽  
David J Kaczorowski ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Cause Of Death ◽  
Lung Transplant ◽  
Acute Hemorrhage ◽  
Ventilator Support ◽  
Common Cause ◽  
Membrane Oxygenation ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Vv Ecmo

Veno-venous extracorporeal membrane oxygenation (VV ECMO) has become an important support modality for patients with acute respiratory failure refractory to optimal medical therapy, such as low tidal volume mechanical ventilator support, early paralytic infusion, and early prone positioning. The objective of this cohort study was to investigate the causes and timing of in-hospital mortality in patients on VV ECMO. All patients, excluding trauma and bridge to lung transplant, admitted 8/2014–6/2019 to a specialty ICU for VV ECMO were reviewed. Two hundred twenty-five patients were included. In-hospital mortality was 24.4% ( n = 55). Most non-survivors (46/55, 84%) died prior to lung recovery and decannulation from VV ECMO. Most common cause of death (COD) for patients who died on VV ECMO was removal of life sustaining therapy (LST) in setting of multisystem organ failure (MSOF) ( n = 24). Nine patients died a median of 9 days [6, 11] after decannulation. Most common COD in these patients was palliative withdrawal of LST due to poor prognosis ( n = 3). Non-survivors were older and had worse predictive mortality scores than survivors. We found that death in patients supported with VV ECMO in our study most often occurs prior to decannulation and lung recovery. This study demonstrated that the most common cause of death in patients supported with VV ECMO was removal of LST due MSOF. Acute hemorrhage (systemic or intracranial) was not found to be a common cause of death in our patient population.

Sign in / Sign up

Export Citation Format

Share Document