Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study.

MedStar author(s):
Citation: Perfusion. 36(6):564-572, 2021 09.PMID: 33021147Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Medicine/Internal Medicine | Medicine/Pulmonary-Critical Care | Surgery/Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *COVID-19 | *Extracorporeal Membrane Oxygenation | *Respiratory Distress Syndrome | Extracorporeal Membrane Oxygenation/ae [Adverse Effects] | Humans | Hypoxia | SARS-CoV-2Year: 2021ISSN:
  • 0267-6591
Name of journal: PerfusionAbstract: CONCLUSION: ECMO is a supportive intervention for COVID-19 associated pneumonia that could be considered if the optimum mechanical ventilation is deemed ineffective. Biomarkers such as D-dimer, LDH, and troponin could help with discerning the clinical prognosis in patients with COVID-19 pneumonia.INTRODUCTION: The pandemic of the coronavirus disease 2019 (COVID-19) and associated pneumonia represent a clinical and scientific challenge. The role of Extracorporeal Membrane Oxygenation (ECMO) in such a crisis remains unclear.METHODS: We examined COVID-19 patients who were supported for acute respiratory failure by both conventional mechanical ventilation (MV) and ECMO at a tertiary care institution in Washington DC. The study period extended from March 23 to April 29. We identified 59 patients who required invasive mechanical ventilation. Of those, 13 patients required ECMO.RESULTS: Nine out of 13 ECMO (69.2%) patients were decannulated from ECMO. All-cause ICU mortality was comparable between both ECMO and MV groups (6 patients [46.15%] vs. 22 patients [47.82 %], p = 0.92). ECMO non-survivors vs survivors had elevated D-dimer (9.740 mcg/ml [4.84-20.00] vs. 3.800 mcg/ml [2.19-9.11], p = 0.05), LDH (1158 +/- 344.5 units/L vs. 575.9 +/- 124.0 units/L, p = 0.001), and troponin (0.4315 +/- 0.465 ng/ml vs. 0.034 +/- 0.043 ng/ml, p = 0.04). Time on MV as expected was significantly longer in ECMO groups (563.3 hours [422.1-613.9] vs. 247.9 hours [101.8-479] in MV group, p = 0.0009) as well as ICU length of stay 576.2 hours [457.5-652.8] in ECMO group vs. 322.2 hours [120.6-569.3] in MV group, p = 0.012).All authors: Alnababteh M, Chopra R, Hashmi MD, Hayat F, Kohli A, Kriner E, Molina E, Oweis E, Pratt A, Vedantam K, Zaaqoq AMOriginally published: Perfusion. :267659120963885, 2020 Oct 06Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2020-12-29
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Journal Article MedStar Authors Catalog Article 33021147 Available 33021147

CONCLUSION: ECMO is a supportive intervention for COVID-19 associated pneumonia that could be considered if the optimum mechanical ventilation is deemed ineffective. Biomarkers such as D-dimer, LDH, and troponin could help with discerning the clinical prognosis in patients with COVID-19 pneumonia.

INTRODUCTION: The pandemic of the coronavirus disease 2019 (COVID-19) and associated pneumonia represent a clinical and scientific challenge. The role of Extracorporeal Membrane Oxygenation (ECMO) in such a crisis remains unclear.

METHODS: We examined COVID-19 patients who were supported for acute respiratory failure by both conventional mechanical ventilation (MV) and ECMO at a tertiary care institution in Washington DC. The study period extended from March 23 to April 29. We identified 59 patients who required invasive mechanical ventilation. Of those, 13 patients required ECMO.

RESULTS: Nine out of 13 ECMO (69.2%) patients were decannulated from ECMO. All-cause ICU mortality was comparable between both ECMO and MV groups (6 patients [46.15%] vs. 22 patients [47.82 %], p = 0.92). ECMO non-survivors vs survivors had elevated D-dimer (9.740 mcg/ml [4.84-20.00] vs. 3.800 mcg/ml [2.19-9.11], p = 0.05), LDH (1158 +/- 344.5 units/L vs. 575.9 +/- 124.0 units/L, p = 0.001), and troponin (0.4315 +/- 0.465 ng/ml vs. 0.034 +/- 0.043 ng/ml, p = 0.04). Time on MV as expected was significantly longer in ECMO groups (563.3 hours [422.1-613.9] vs. 247.9 hours [101.8-479] in MV group, p = 0.0009) as well as ICU length of stay 576.2 hours [457.5-652.8] in ECMO group vs. 322.2 hours [120.6-569.3] in MV group, p = 0.012).

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