ASAIO J . Extracorporeal Membrane Oxygenation and Extracorporeal Cardiopulmonary Resuscitation for a COVID-19 Paediatric Patient: A Successful Outc

[tetano]

ASAIO J


. 2020 Dec 28;Publish Ahead of Print.
doi: 10.1097/MAT.0000000000001377. Online ahead of print.
Extracorporeal Membrane Oxygenation and Extracorporeal Cardiopulmonary Resuscitation for a COVID-19 Paediatric Patient: A Successful Outcome


Huda Alfoudri[SUP] 1 [/SUP], Mohammad Shamsah, Beena Yousuf, Nasayem AlQuraini



Affiliations

• PMID: 33394689
• DOI: 10.1097/MAT.0000000000001377

Abstract

Paediatric population have been affected by the Coronavirus disease 2019 (COVID-19) to a much smaller scale compared to the adult population. The severity of the disease is variable ranging from mild form of pneumonia to severe Acute Respiratory Distress Syndrome (ARDS) that necessitates admission to the Intensive Care Unit (ICU) requiring maximal level of organ support. Failure of the maximum support through mechanical ventilation can lead to the consideration of a higher level of organ support through extracorporeal membrane oxygenation (ECMO). We present a case of an 8 years old girl, who presented with severe ARDS secondary to COVID-19 pneumonia for which a venovenous-extracorporeal membrane oxygenation (VV ECMO) was initiated. This was followed by the patient developing cardiac arrest which was managed with extracorporeal cardiopulmonary resuscitation (ECPR). The patient was also given thrombolytic therapy during the ECPR due to high clinical suspicion for pulmonary embolism. VV-A ECMO was then continued and the patient was successfully weaned off both VA and VV ECMO and discharged home with full neurological recovery. This encouraging result will hopefully lead to more consideration of this lifesaving therapy for severe cardiac and respiratory failure secondary to COVID-19 in paediatric patients.

 

[tetano]

ASAIO J


. 2020 Dec 28;Publish Ahead of Print.
doi: 10.1097/MAT.0000000000001376. Online ahead of print.
Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Crisis Standards of Care


Cara Agerstrand[SUP] 1 [/SUP], Richard Dubois, Koji Takeda, Nir Uriel, Philippe Lemaitre, Justin Fried, Amirali Masoumi, Eva W Cheung, Yuji Kaku, Lucas Witer, Peter Liou, Claire Gerall, Rafael Klein-Cloud, Darryl Abrams, Jennifer Cunningham, Purnema Madahar, Madhavi Parekh, Briana Short, Natalie H Yip, Alexis Serra, James Beck, Michael Brewer, Kenmund Fung, Dana Mullin, Roy Oommen, B Payne Stanifer, William Middlesworth, Joshua Sonett, Daniel Brodie



Affiliations

• PMID: 33394688
• DOI: 10.1097/MAT.0000000000001376

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has placed extraordinary strain on global healthcare systems. Use of extracorporeal membrane oxygenation (ECMO) for patients with severe respiratory or cardiac failure attributed to COVID-19 has been debated due to uncertain survival benefit and the resources required to safely deliver ECMO support. We retrospectively investigated adult patients supported with ECMO for COVID-19 at our institution during the first 80 days following New York City's declaration of a state of emergency. The primary objective was to evaluate survival outcomes in patients supported with ECMO for COVID-19 and describe the programmatic adaptations made in response to pandemic-related crisis conditions. Twenty-two patients with COVID-19 were placed on ECMO during the study period. Median age was 52 years and 18 (81.8%) were male. Twenty-one patients (95.4%) had severe ARDS and 7 (31.8%) had cardiac failure. Fifteen patients (68.1%) were managed with venovenous ECMO while 7 (31.8%) required arterial support. Twelve patients (54.5%) were transported on ECMO from external institutions. Twelve patients were discharged alive from the hospital (54.5%). ECMO was used successfully in patients with respiratory and cardiac failure due to COVID-19. The continued use of ECMO, including ECMO transport, during crisis conditions was possible even at the height of the COVID-19 pandemic.