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Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases

WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to...

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Autores principales: Ramanathan, Kollengode, Antognini, David, Combes, Alain, Paden, Matthew, Zakhary, Bishoy, Ogino, Mark, MacLaren, Graeme, Brodie, Daniel, Shekar, Kiran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102637/
https://www.ncbi.nlm.nih.gov/pubmed/32203711
http://dx.doi.org/10.1016/S2213-2600(20)30121-1
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author Ramanathan, Kollengode
Antognini, David
Combes, Alain
Paden, Matthew
Zakhary, Bishoy
Ogino, Mark
MacLaren, Graeme
Brodie, Daniel
Shekar, Kiran
author_facet Ramanathan, Kollengode
Antognini, David
Combes, Alain
Paden, Matthew
Zakhary, Bishoy
Ogino, Mark
MacLaren, Graeme
Brodie, Daniel
Shekar, Kiran
author_sort Ramanathan, Kollengode
collection PubMed
description WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality.
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spelling pubmed-71026372020-03-31 Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases Ramanathan, Kollengode Antognini, David Combes, Alain Paden, Matthew Zakhary, Bishoy Ogino, Mark MacLaren, Graeme Brodie, Daniel Shekar, Kiran Lancet Respir Med Health-care Development WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality. Elsevier Ltd. 2020-05 2020-03-20 /pmc/articles/PMC7102637/ /pubmed/32203711 http://dx.doi.org/10.1016/S2213-2600(20)30121-1 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Health-care Development
Ramanathan, Kollengode
Antognini, David
Combes, Alain
Paden, Matthew
Zakhary, Bishoy
Ogino, Mark
MacLaren, Graeme
Brodie, Daniel
Shekar, Kiran
Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
title Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
title_full Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
title_fullStr Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
title_full_unstemmed Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
title_short Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases
title_sort planning and provision of ecmo services for severe ards during the covid-19 pandemic and other outbreaks of emerging infectious diseases
topic Health-care Development
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102637/
https://www.ncbi.nlm.nih.gov/pubmed/32203711
http://dx.doi.org/10.1016/S2213-2600(20)30121-1
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