tetano
Editor, Senior Moderator
J Intensive Care
. 2023 Feb 8;11(1):5.
doi: 10.1186/s40560-023-00654-7.
Extracorporeal membrane oxygenation for COVID-19-related acute respiratory distress syndrome: a narrative review
Francesco Alessandri[SUP] #[/SUP][SUP] 1 [/SUP], Matteo Di Nardo[SUP] #[/SUP][SUP] 2 [/SUP], Kollengode Ramanathan[SUP] 3 [/SUP], Daniel Brodie[SUP] 4 5 [/SUP], Graeme MacLaren[SUP] 6 [/SUP]
Affiliations
Abstract
A growing body of evidence supports the use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) refractory to maximal medical therapy. ARDS may develop in a proportion of patients hospitalized for coronavirus disease 2019 (COVID-19) and ECMO may be used to manage patients refractory to maximal medical therapy to mitigate the risk of ventilator-induced lung injury and provide lung rest while awaiting recovery. The mortality of COVID-19-related ARDS was variously reassessed during the pandemic. Veno-venous (VV) ECMO was the default choice to manage refractory respiratory failure; however, with concomitant severe right ventricular dysfunction, venoarterial (VA) ECMO or mechanical right ventricular assist devices with extracorporeal gas exchange (Oxy-RVAD) were also considered. ECMO has also been used to manage special populations such as pregnant women, pediatric patients affected by severe forms of COVID-19, and, in cases with persistent and seemingly irreversible respiratory failure, as a bridge to successful lung transplantation. In this narrative review, we outline and summarize the most recent evidence that has emerged on ECMO use in different patient populations with COVID-19-related ARDS.
Keywords: ARDS; COVID-19; ECMO; Extracorporeal life support; Extracorporeal membrane oxygenation; Respiratory failure.
. 2023 Feb 8;11(1):5.
doi: 10.1186/s40560-023-00654-7.
Extracorporeal membrane oxygenation for COVID-19-related acute respiratory distress syndrome: a narrative review
Francesco Alessandri[SUP] #[/SUP][SUP] 1 [/SUP], Matteo Di Nardo[SUP] #[/SUP][SUP] 2 [/SUP], Kollengode Ramanathan[SUP] 3 [/SUP], Daniel Brodie[SUP] 4 5 [/SUP], Graeme MacLaren[SUP] 6 [/SUP]
Affiliations
- PMID: 36755270
- DOI: 10.1186/s40560-023-00654-7
Abstract
A growing body of evidence supports the use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) refractory to maximal medical therapy. ARDS may develop in a proportion of patients hospitalized for coronavirus disease 2019 (COVID-19) and ECMO may be used to manage patients refractory to maximal medical therapy to mitigate the risk of ventilator-induced lung injury and provide lung rest while awaiting recovery. The mortality of COVID-19-related ARDS was variously reassessed during the pandemic. Veno-venous (VV) ECMO was the default choice to manage refractory respiratory failure; however, with concomitant severe right ventricular dysfunction, venoarterial (VA) ECMO or mechanical right ventricular assist devices with extracorporeal gas exchange (Oxy-RVAD) were also considered. ECMO has also been used to manage special populations such as pregnant women, pediatric patients affected by severe forms of COVID-19, and, in cases with persistent and seemingly irreversible respiratory failure, as a bridge to successful lung transplantation. In this narrative review, we outline and summarize the most recent evidence that has emerged on ECMO use in different patient populations with COVID-19-related ARDS.
Keywords: ARDS; COVID-19; ECMO; Extracorporeal life support; Extracorporeal membrane oxygenation; Respiratory failure.