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One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19
BACKGROUND: Severe coronavirus disease 2019 (COVID-19) can cause acute respiratory failure requiring mechanical ventilation. Venovenous (VV) extracorporeal membrane oxygenation (ECMO) has been used in patients in whom conventional mechanical ventilatory support has failed. To date, published data ha...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
by The Society of Thoracic Surgeons
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907014/ https://www.ncbi.nlm.nih.gov/pubmed/35282865 http://dx.doi.org/10.1016/j.athoracsur.2022.01.003 |
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author | Smith, Deane E. Chang, Stephanie H. Geraci, Travis C. James, Les Kon, Zachary N. Carillo, Julius A. Alimi, Marjan Williams, David Scheinerman, Joshua A. Cerfolio, Robert J. Grossi, Eugene A. Moazami, Nader Galloway, Aubrey C. |
author_facet | Smith, Deane E. Chang, Stephanie H. Geraci, Travis C. James, Les Kon, Zachary N. Carillo, Julius A. Alimi, Marjan Williams, David Scheinerman, Joshua A. Cerfolio, Robert J. Grossi, Eugene A. Moazami, Nader Galloway, Aubrey C. |
author_sort | Smith, Deane E. |
collection | PubMed |
description | BACKGROUND: Severe coronavirus disease 2019 (COVID-19) can cause acute respiratory failure requiring mechanical ventilation. Venovenous (VV) extracorporeal membrane oxygenation (ECMO) has been used in patients in whom conventional mechanical ventilatory support has failed. To date, published data have focused on survival from ECMO and survival to discharge. In addition to survival to discharge, this study reports 1-year follow-up data for patients who were successfully discharged from the hospital. METHODS: A single-institution, retrospective review of all patients with severe COVID-19 who were cannulated for VV-ECMO between March 10, 2020 and May 1, 2020 was performed. A multidisciplinary ECMO team evaluated, selected, and managed patients with ECMO support. The primary outcome of this study was survival to discharge. Available 1-year follow-up data are also reported. RESULTS: A total of 30 patients were supported with VV-ECMO, and 27 patients (90%) survived to discharge. All patients were discharged home or to acute rehabilitation on room air, except for 1 patient (3.7%), who required supplemental oxygen therapy. At a median follow-up of 10.8 months (interquartile range [IQR], 8.9-14.4 months) since ECMO cannulation, survival was 86.7%, including 1 patient who underwent lung transplantation. Of the patients discharged from the hospital, 44.4% (12/27) had pulmonary function testing, with a median percent predicted forced expiratory volume of 100% (IQR, 91%-110%). For survivors, a 6-minute walk test was performed in 59.3% (16/27), with a median value of 350 m (IQR, 286-379 m). CONCLUSIONS: A well-defined patient selection and management strategy of VV-ECMO support in patients with severe COVID-19 resulted in exceptional survival to discharge that was sustained at 1-year after ECMO cannulation. |
format | Online Article Text |
id | pubmed-8907014 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | by The Society of Thoracic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-89070142022-03-10 One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 Smith, Deane E. Chang, Stephanie H. Geraci, Travis C. James, Les Kon, Zachary N. Carillo, Julius A. Alimi, Marjan Williams, David Scheinerman, Joshua A. Cerfolio, Robert J. Grossi, Eugene A. Moazami, Nader Galloway, Aubrey C. Ann Thorac Surg Original Article BACKGROUND: Severe coronavirus disease 2019 (COVID-19) can cause acute respiratory failure requiring mechanical ventilation. Venovenous (VV) extracorporeal membrane oxygenation (ECMO) has been used in patients in whom conventional mechanical ventilatory support has failed. To date, published data have focused on survival from ECMO and survival to discharge. In addition to survival to discharge, this study reports 1-year follow-up data for patients who were successfully discharged from the hospital. METHODS: A single-institution, retrospective review of all patients with severe COVID-19 who were cannulated for VV-ECMO between March 10, 2020 and May 1, 2020 was performed. A multidisciplinary ECMO team evaluated, selected, and managed patients with ECMO support. The primary outcome of this study was survival to discharge. Available 1-year follow-up data are also reported. RESULTS: A total of 30 patients were supported with VV-ECMO, and 27 patients (90%) survived to discharge. All patients were discharged home or to acute rehabilitation on room air, except for 1 patient (3.7%), who required supplemental oxygen therapy. At a median follow-up of 10.8 months (interquartile range [IQR], 8.9-14.4 months) since ECMO cannulation, survival was 86.7%, including 1 patient who underwent lung transplantation. Of the patients discharged from the hospital, 44.4% (12/27) had pulmonary function testing, with a median percent predicted forced expiratory volume of 100% (IQR, 91%-110%). For survivors, a 6-minute walk test was performed in 59.3% (16/27), with a median value of 350 m (IQR, 286-379 m). CONCLUSIONS: A well-defined patient selection and management strategy of VV-ECMO support in patients with severe COVID-19 resulted in exceptional survival to discharge that was sustained at 1-year after ECMO cannulation. by The Society of Thoracic Surgeons 2022-07 2022-03-10 /pmc/articles/PMC8907014/ /pubmed/35282865 http://dx.doi.org/10.1016/j.athoracsur.2022.01.003 Text en © 2022 by The Society of Thoracic Surgeons. 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 | Original Article Smith, Deane E. Chang, Stephanie H. Geraci, Travis C. James, Les Kon, Zachary N. Carillo, Julius A. Alimi, Marjan Williams, David Scheinerman, Joshua A. Cerfolio, Robert J. Grossi, Eugene A. Moazami, Nader Galloway, Aubrey C. One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 |
title | One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 |
title_full | One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 |
title_fullStr | One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 |
title_full_unstemmed | One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 |
title_short | One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 |
title_sort | one-year outcomes with venovenous extracorporeal membrane oxygenation support for severe covid-19 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907014/ https://www.ncbi.nlm.nih.gov/pubmed/35282865 http://dx.doi.org/10.1016/j.athoracsur.2022.01.003 |
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