Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study
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 r...
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| Veröffentlicht in: | Perfusion 2021-09, Vol.36 (6), p.564-572 |
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| creator | Alnababteh, Muhtadi Hashmi, Muhammad D Vedantam, Karthik Chopra, Rajus Kohli, Akshay Hayat, Fatima Kriner, Eric Molina, Ezequiel Pratt, Alexandra Oweis, Emil Zaaqoq, Akram M |
| description | 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).
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. |
| doi_str_mv | 10.1177/0267659120963885 |
| format | Article |
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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).
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.</description><identifier>ISSN: 0267-6591</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/0267659120963885</identifier><identifier>PMID: 33021147</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Biomarkers ; Calcium-binding protein ; Coronaviruses ; COVID-19 ; Dimers ; Extracorporeal membrane oxygenation ; Hypoxia ; Mechanical ventilation ; Membranes ; Oxygenation ; Pandemics ; Patients ; Pneumonia ; Respiratory failure ; Troponin ; Ventilation ; Ventilators ; Viral diseases</subject><ispartof>Perfusion, 2021-09, Vol.36 (6), p.564-572</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-11e0ba7897d620dfdfd3215a665f509a48cc343f0a7ad959a6a44698ff623c0f3</citedby><cites>FETCH-LOGICAL-c473t-11e0ba7897d620dfdfd3215a665f509a48cc343f0a7ad959a6a44698ff623c0f3</cites><orcidid>0000-0001-8521-9260</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0267659120963885$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0267659120963885$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33021147$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alnababteh, Muhtadi</creatorcontrib><creatorcontrib>Hashmi, Muhammad D</creatorcontrib><creatorcontrib>Vedantam, Karthik</creatorcontrib><creatorcontrib>Chopra, Rajus</creatorcontrib><creatorcontrib>Kohli, Akshay</creatorcontrib><creatorcontrib>Hayat, Fatima</creatorcontrib><creatorcontrib>Kriner, Eric</creatorcontrib><creatorcontrib>Molina, Ezequiel</creatorcontrib><creatorcontrib>Pratt, Alexandra</creatorcontrib><creatorcontrib>Oweis, Emil</creatorcontrib><creatorcontrib>Zaaqoq, Akram M</creatorcontrib><title>Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>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).
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.</description><subject>Biomarkers</subject><subject>Calcium-binding protein</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Dimers</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Hypoxia</subject><subject>Mechanical ventilation</subject><subject>Membranes</subject><subject>Oxygenation</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Respiratory failure</subject><subject>Troponin</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Viral diseases</subject><issn>0267-6591</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kM9LwzAUx4Mobk7vnqTgxUs1v5o03mROHQx20Im3kqXJ7GibmrSw_vdmbCoM5B3e4X3e933fF4BLBG8R4vwOYsZZIhCGgpE0TY7AEFHOY4TQxzEYbsfxdj4AZ96vIYSUUnIKBoRAjAI5BIvJpnVSWddYp2UZVbpaOlnryG76la5lW9g6MtZF4_n79DFGIirqvFM6jz77xm4KeR-9FvWq1LHSdatd5Nsu78_BiZGl1xf7PgKLp8nb-CWezZ-n44dZrCgnbbCp4VLyVPCcYZibUASjRDKWmAQKSVOlCCUGSi5zkQjJJKVMpMYwTBQ0ZARudrqNs1-d9m1WFV7psgwf2M5nmNKQCuScBfT6AF3bztXBXYYThlLGRUoDBXeUctZ7p03WuKKSrs8QzLaRZ4eRh5WrvXC3rHT-u_CTcQDiHeDlSv9d_VfwG48Th34</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Alnababteh, Muhtadi</creator><creator>Hashmi, Muhammad D</creator><creator>Vedantam, Karthik</creator><creator>Chopra, Rajus</creator><creator>Kohli, Akshay</creator><creator>Hayat, Fatima</creator><creator>Kriner, Eric</creator><creator>Molina, Ezequiel</creator><creator>Pratt, Alexandra</creator><creator>Oweis, Emil</creator><creator>Zaaqoq, Akram M</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8521-9260</orcidid></search><sort><creationdate>20210901</creationdate><title>Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study</title><author>Alnababteh, Muhtadi ; Hashmi, Muhammad D ; Vedantam, Karthik ; Chopra, Rajus ; Kohli, Akshay ; Hayat, Fatima ; Kriner, Eric ; Molina, Ezequiel ; Pratt, Alexandra ; Oweis, Emil ; Zaaqoq, Akram M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-11e0ba7897d620dfdfd3215a665f509a48cc343f0a7ad959a6a44698ff623c0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biomarkers</topic><topic>Calcium-binding protein</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Dimers</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Hypoxia</topic><topic>Mechanical ventilation</topic><topic>Membranes</topic><topic>Oxygenation</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Respiratory failure</topic><topic>Troponin</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Viral diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alnababteh, Muhtadi</creatorcontrib><creatorcontrib>Hashmi, Muhammad D</creatorcontrib><creatorcontrib>Vedantam, Karthik</creatorcontrib><creatorcontrib>Chopra, Rajus</creatorcontrib><creatorcontrib>Kohli, Akshay</creatorcontrib><creatorcontrib>Hayat, Fatima</creatorcontrib><creatorcontrib>Kriner, Eric</creatorcontrib><creatorcontrib>Molina, Ezequiel</creatorcontrib><creatorcontrib>Pratt, Alexandra</creatorcontrib><creatorcontrib>Oweis, Emil</creatorcontrib><creatorcontrib>Zaaqoq, Akram M</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alnababteh, Muhtadi</au><au>Hashmi, Muhammad D</au><au>Vedantam, Karthik</au><au>Chopra, Rajus</au><au>Kohli, Akshay</au><au>Hayat, Fatima</au><au>Kriner, Eric</au><au>Molina, Ezequiel</au><au>Pratt, Alexandra</au><au>Oweis, Emil</au><au>Zaaqoq, Akram M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>36</volume><issue>6</issue><spage>564</spage><epage>572</epage><pages>564-572</pages><issn>0267-6591</issn><eissn>1477-111X</eissn><abstract>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).
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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>33021147</pmid><doi>10.1177/0267659120963885</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8521-9260</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biomarkers Calcium-binding protein Coronaviruses COVID-19 Dimers Extracorporeal membrane oxygenation Hypoxia Mechanical ventilation Membranes Oxygenation Pandemics Patients Pneumonia Respiratory failure Troponin Ventilation Ventilators Viral diseases |
| title | Extracorporeal membrane oxygenation for COVID-19 induced hypoxia: Single-center study |
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