[Recommendations for Extracorporeal Membrane Oxygenation (ECMO) in COVID-19 Patients]

Overview

Journal Wien Klin Mag

Publisher Springer

Specialty General Medicine

Date 2020 Aug 25

PMID 32837601

Authors

Dominik Wiedemann

Martin H Bernardi

Klaus Distelmaier

Georg Goliasch

Christian Hengstenberg

Alexander Hermann

Michael Holzer

Konrad Hoetzenecker

Walter Klepetko

Gyorgy Lang

Andrea Lassnigg

Gunther Laufer

Ingrid A M Magnet

Klaus Markstaller

Martin Roggla

Bernhard Rossler

Peter Schellongowski

Paul Simon

Edda Tschernko

Roman Ullrich

Daniel Zimpfer

Thomas Staudinger

Affiliations

Soon will be listed here.

Abstract

The pandemic from the SARS-CoV‑2 Virus is currently challenging health care systems all over the world. Maintaining appropriate staffing and resources in healthcare facilities is essential to guarantee a safe work environment for healthcare personnel and safe patient care. Extracorporeal membrane oxygenation (ECMO) represents a valuable therapeutic option in patients with severe heart or lung failure. Although only a limited proportion of COVID-19 patients develops respiratory or circulatory failure that is refractory to conventional therapies, it is of utmost importance to clearly define criteria for the use of ECMOs in this steadily growing patient population. The ECMO working group of the Medical University of Vienna has established the following recommendations for ECMO support in COVID-19 patients.

References

Pichler P, Antretter H, Dunser M, Eschertzhuber S, Gottardi R, Heinz G . [Use of ECMO in adult patients with cardiogenic shock: a position paper of the Austrian Society of Cardiology]. Wien Klin Wochenschr. 2015; 127(5-6):169-84. DOI: 10.1007/s00508-015-0743-5. View

Schmidt M, Pellegrino V, Combes A, Scheinkestel C, Cooper D, Hodgson C . Mechanical ventilation during extracorporeal membrane oxygenation. Crit Care. 2014; 18(1):203. PMC: 4057516. DOI: 10.1186/cc13702. View

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J . Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-1069. PMC: 7042881. DOI: 10.1001/jama.2020.1585. View

Bartlett R, Ogino M, Brodie D, McMullan D, Lorusso R, MacLaren G . Initial ELSO Guidance Document: ECMO for COVID-19 Patients with Severe Cardiopulmonary Failure. ASAIO J. 2020; 66(5):472-474. PMC: 7273858. DOI: 10.1097/MAT.0000000000001173. View

De Geer L, Fredrikson M, Tibblin A . Frailty predicts 30-day mortality in intensive care patients: A prospective prediction study. Eur J Anaesthesiol. 2020; 37(11):1058-1065. DOI: 10.1097/EJA.0000000000001156. View

Poppe M, Schriefl C, Steinacher A, Clodi C, Warenits A, Nurnberger A . Extracorporeal cardiopulmonary resuscitation at the emergency department: A retrospective patient selection evaluation. Eur J Anaesthesiol. 2019; 37(4):280-285. DOI: 10.1097/EJA.0000000000001142. View

Serpa Neto A, Schmidt M, Azevedo L, Bein T, Brochard L, Beutel G . Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis : Mechanical ventilation during.... Intensive Care Med. 2016; 42(11):1672-1684. PMC: 7094949. DOI: 10.1007/s00134-016-4507-0. View

Camboni D, Philipp A, Lubnow M, Bein T, Haneya A, Diez C . Support time-dependent outcome analysis for veno-venous extracorporeal membrane oxygenation. Eur J Cardiothorac Surg. 2011; 40(6):1341-6. DOI: 10.1016/j.ejcts.2011.03.062. View

Combes A, Hajage D, Capellier G, Demoule A, Lavoue S, Guervilly C . Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. N Engl J Med. 2018; 378(21):1965-1975. DOI: 10.1056/NEJMoa1800385. View

10.

Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M . Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir Med. 2020; 8(5):518-526. PMC: 7102637. DOI: 10.1016/S2213-2600(20)30121-1. View

11.

Lotz C, Ritter O, Muellenbach R . Assisted beating of the ischemic heart: how to manage the pulseless ST--segment-elevation myocardial infarction patient. Circulation. 2014; 130(13):1095-104. DOI: 10.1161/CIRCULATIONAHA.114.009270. View

12.

Hu H, Ma F, Wei X, Fang Y . Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J. 2020; 42(2):206. PMC: 7184348. DOI: 10.1093/eurheartj/ehaa190. View

13.

Fan E, Del Sorbo L, Goligher E, Hodgson C, Munshi L, Walkey A . An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017; 195(9):1253-1263. DOI: 10.1164/rccm.201703-0548ST. View

14.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506. PMC: 7159299. DOI: 10.1016/S0140-6736(20)30183-5. View

15.

Grasselli G, Pesenti A, Cecconi M . Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020; 323(16):1545-1546. DOI: 10.1001/jama.2020.4031. View

16.

Posluszny J, Rycus P, Bartlett R, Engoren M, Haft J, Lynch W . Outcome of Adult Respiratory Failure Patients Receiving Prolonged (≥14 Days) ECMO. Ann Surg. 2015; 263(3):573-81. DOI: 10.1097/SLA.0000000000001176. View

17.

Papazian L, Aubron C, Brochard L, Chiche J, Combes A, Dreyfuss D . Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care. 2019; 9(1):69. PMC: 6565761. DOI: 10.1186/s13613-019-0540-9. View