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A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO
PURPOSE: Extracorporeal Membrane Oxygenation (ECMO) has been utilized as salvage therapy in patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19. We aim to present our experience with ECMO in a community hospital for minority patients with COVID-19. METHODS: This is a retro...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Published by Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979395/ http://dx.doi.org/10.1016/j.healun.2021.01.1122 |
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author | Quesada, C. Tejera Chen, K. Reddy, R. Grajeda, E. Dayanand, P. Sabates, A. Ghumman, W. Chait, R. |
author_facet | Quesada, C. Tejera Chen, K. Reddy, R. Grajeda, E. Dayanand, P. Sabates, A. Ghumman, W. Chait, R. |
author_sort | Quesada, C. Tejera |
collection | PubMed |
description | PURPOSE: Extracorporeal Membrane Oxygenation (ECMO) has been utilized as salvage therapy in patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19. We aim to present our experience with ECMO in a community hospital for minority patients with COVID-19. METHODS: This is a retrospective analysis of all SARS-CoV2 infected patients who developed ARDS and received ECMO at a tertiary cardiovascular care center between March and August 2020. Patient demographics, data pre- and on-ECMO, hemodynamics, and ventilation parameters were collected. Primary outcome of interest was mortality. Secondary outcomes were length of stay, bleeding requiring transfusion, coagulopathies, infections, and procedural-related complications. RESULTS: We identified 10 COVID-19 patients with ARDS treated with ECMO. The mean age was 45 years and 70% were male. The racial composition of the patients consisted of Blacks (30%) and Hispanics (70%). Comorbidities included hypertension (40%), diabetes mellitus (50%), and hyperlipidemia (20%). Eight patients were treated with VV-ECMO, and the remaining patients with VA-ECMO. Hospital-acquired infections including ventilator-associated pneumonia and bacteremia were reported in 50% and 30%, respectively. Hemorrhage requiring transfusion was reported in all 10 patients, with 60% of patients having bleeding from a gastrointestinal source. 70% of patients developed thrombocytopenia, and 20% developed a clot within the ECMO circuit. Coagulation disorders reported, included heparin-induced thrombocytopenia (20%), deep vein thrombosis (30%), and pulmonary embolism (20%). 90% of patients died, and 1 patient was discharged to a long-term acute care hospital (See Table 1 for outcomes). CONCLUSION: Despite using ECMO as rescue therapy, mortality among COVID-19 patients who developed ARDS remained high in minority groups. Further studies are needed to investigate management of COVID-19 related complications. |
format | Online Article Text |
id | pubmed-7979395 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79793952021-03-23 A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO Quesada, C. Tejera Chen, K. Reddy, R. Grajeda, E. Dayanand, P. Sabates, A. Ghumman, W. Chait, R. J Heart Lung Transplant 1005 PURPOSE: Extracorporeal Membrane Oxygenation (ECMO) has been utilized as salvage therapy in patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19. We aim to present our experience with ECMO in a community hospital for minority patients with COVID-19. METHODS: This is a retrospective analysis of all SARS-CoV2 infected patients who developed ARDS and received ECMO at a tertiary cardiovascular care center between March and August 2020. Patient demographics, data pre- and on-ECMO, hemodynamics, and ventilation parameters were collected. Primary outcome of interest was mortality. Secondary outcomes were length of stay, bleeding requiring transfusion, coagulopathies, infections, and procedural-related complications. RESULTS: We identified 10 COVID-19 patients with ARDS treated with ECMO. The mean age was 45 years and 70% were male. The racial composition of the patients consisted of Blacks (30%) and Hispanics (70%). Comorbidities included hypertension (40%), diabetes mellitus (50%), and hyperlipidemia (20%). Eight patients were treated with VV-ECMO, and the remaining patients with VA-ECMO. Hospital-acquired infections including ventilator-associated pneumonia and bacteremia were reported in 50% and 30%, respectively. Hemorrhage requiring transfusion was reported in all 10 patients, with 60% of patients having bleeding from a gastrointestinal source. 70% of patients developed thrombocytopenia, and 20% developed a clot within the ECMO circuit. Coagulation disorders reported, included heparin-induced thrombocytopenia (20%), deep vein thrombosis (30%), and pulmonary embolism (20%). 90% of patients died, and 1 patient was discharged to a long-term acute care hospital (See Table 1 for outcomes). CONCLUSION: Despite using ECMO as rescue therapy, mortality among COVID-19 patients who developed ARDS remained high in minority groups. Further studies are needed to investigate management of COVID-19 related complications. Published by Elsevier Inc. 2021-04 2021-03-20 /pmc/articles/PMC7979395/ http://dx.doi.org/10.1016/j.healun.2021.01.1122 Text en Copyright © 2021 Published by Elsevier Inc. 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 | 1005 Quesada, C. Tejera Chen, K. Reddy, R. Grajeda, E. Dayanand, P. Sabates, A. Ghumman, W. Chait, R. A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO |
title | A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO |
title_full | A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO |
title_fullStr | A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO |
title_full_unstemmed | A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO |
title_short | A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO |
title_sort | case series of black and hispanic covid-19 patients treated with ecmo |
topic | 1005 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979395/ http://dx.doi.org/10.1016/j.healun.2021.01.1122 |
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