Article
Critical Care Medicine
Jad Malas, Qiudong Chen, Tao Shen, Dominic Emerson, Tyler Gunn, Dominick Megna, Pedro Catarino, Michael Nurok, Michael Bowdish, Joanna Chikwe, Susan Cheng, Joseph Ebinger, Abirami Kumaresan
Summary: This study aimed to describe the institutional experience with extremely prolonged venovenous extracorporeal membrane oxygenation (ECMO) support for patients with acute respiratory failure. The study found that most patients in this cohort had adult respiratory distress syndrome (ARDS) secondary to COVID-19. Prolonged ECMO support was successful in weaning patients off and enabling their recovery, with a high rate of survival.
CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Darya Rudym, Tai Pham, Craig R. Rackley, Giacomo Grasselli, Michaela Anderson, Matthew R. Baldwin, Jeremy Beitler, Cara Agerstrand, Alexis Serra, Lisle A. Winston, Desiree Bonadonna, Natalie Yip, Logan J. Emerson, Amy Dzierba, Joshua Sonett, Darryl Abrams, Niall D. Ferguson, Matthew Bacchetta, Matthieu Schmidt, Daniel Brodie
Summary: This study investigated the association between obesity and mortality in patients with ARDS receiving ECMO. The results showed that patients with obesity had lower ICU mortality than patients without obesity, supporting the idea that obesity should not be considered a general contraindication to ECMO.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Jonathan K. Zakrajsek, Sung -Joon Min, P. Michael Ho, Tyree H. Kiser, Arun Kannappan, Peter D. Sottile, Richard R. Allen, Meghan D. Althoff, Paul M. Reynolds, Marc Moss, Ellen L. Burnham, Mark E. Mikkelsen, R. William Vandivier
Summary: This retrospective cohort study analyzed 13,714 patients with asthma exacerbations and respiratory failure, including 127 treated with ECMO and 13,587 without ECMO. The results showed that ECMO treatment was associated with lower mortality but higher hospital costs compared to standard care. These findings suggest that ECMO may be an important salvage therapy for refractory asthma exacerbations with respiratory failure.
Review
Critical Care Medicine
Ricardo Teijeiro-Paradis, Whitney D. Gannon, Eddy Fan
Summary: This narrative review discusses the various complications that can occur during treatment with venovenous extracorporeal membrane oxygenation (V-V ECMO), including both short-term and long-term complications. Patient selection, timing of initiation, and management decisions greatly influence the presence and severity of these potential harms.
CRITICAL CARE MEDICINE
(2022)
Article
Surgery
Perisa Ruhi-Williams, Baolin Wu, Jeffry Nahmias, Fabio Sagebin, Reza Fazl Alizadeh, Kishore M. Gadde, Alpesh Amin, Ninh T. Nguyen
Summary: This study analyzed the characteristics and outcomes of veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) due to COVID-19 versus non-COVID causes. The results showed that patients with COVID-19 ARDS requiring V-V ECMO support had higher in-hospital mortality, longer length of stay, and higher direct hospitalization cost compared to non-COVID etiologies.
Article
Medicine, General & Internal
Jing Hua, Xin Zhang, Na Wang, Linyu Ran, Shengyun Wang, Chiungwei Huang, Wei Gao, Chenchen Qian, Wei Guo, Zhongmin Liu, Qiang Li, Feilong Wang
Summary: ECMO may be an effective treatment for critically ill patients with COVID-19, but careful patient selection and management by a trained team are crucial. More randomized controlled trials with larger sample sizes are needed to evaluate the actual effectiveness of ECMO in patients with COVID-19.
FRONTIERS IN MEDICINE
(2021)
Article
Critical Care Medicine
Michael Kouch, Adam Green, Emily Damuth, Christopher Noel, Jason Bartock, Michael Rosenbloom, Christa Schorr, Robert Rios, Nancy Loperfido, Nitin Puri
Summary: This study compared the effectiveness of cardiothoracic surgeons and medical intensivists in performing extracorporeal membrane oxygenation cannulation. The results showed that there was no difference in success and complication rates between the two groups in an established extracorporeal membrane oxygenation program. A rapidly deployed cannulation program led by intensivists for venovenous extracorporeal membrane oxygenation can be performed with high success and low complication rates.
CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Matthias Kochanek, Jan Kochanek, Boris Boell, Dennis A. Eichenauer, Gernot Beutel, Hendrik Bracht, Stephan Braune, Florian Eisner, Sigrun Friesecke, Ulf Guenther, Gottfried Heinz, Michael Hallek, Christian Karagiannidis, Stefan Kluge, Klaus Kogelmann, Pia Lebiedz, Philipp M. Lepper, Tobias Liebregts, Catherina Lueck, Ralf M. Muellenbach, Matthias Hansen, Christian Putensen, Peter Schellongowski, Jens-Christian Schewe, Kathrin Schumann-Stoiber, Frederik Seiler, Peter Spieth, Steffen Weber-Carstens, Daniel Brodie, Elie Azoulay, Alexander Shimabukuro-Vornhagen
Summary: The overall survival of cancer patients requiring vv-ECMO is poor, and the value of vv-ECMO in cancer patients with respiratory failure remains unclear. Further research is needed to determine the benefits of vv-ECMO in this population. The risk factors identified in this study may help in better selection of patients who may benefit from vv-ECMO.
INTENSIVE CARE MEDICINE
(2022)
Review
Critical Care Medicine
Wynne Hsing Poon, Kollengode Ramanathan, Ryan Ruiyang Ling, Isabelle Xiaorui Yang, Chuen Seng Tan, Matthieu Schmidt, Kiran Shekar
Summary: Prone positioning during VV ECMO treatment for ARDS patients can improve survival rates, but may result in longer ICU stays and ECMO durations.
Article
Cardiac & Cardiovascular Systems
J. W. Awori Hayanga, Subhasis Chatterjee, Bo Soo Kim, HelenMari Merritt-Genore, Rita Carrie Karianna Milewski, Jonathan W. Haft, Rakesh C. Arora
Summary: The high transmissibility of SARS-CoV-2 and severity of COVID-19 have created a global health emergency. The virus enters host cells through the spike membrane protein, with angiotensin-converting enzyme 2 as the receptor. The pandemic has tested the global health infrastructure and led to the exploration of new strategies. ECMO has been used as a rescue option, but there is no consensus on a specific scoring system for its severity assessment.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Critical Care Medicine
Oliver Hunsicker, Lukas Beck, Alexander Krannich, Tobias Finger, Vincent Prinz, Claudia Spies, Steffen Weber-Carstens, Stefan Wolf, Jan Adriaan Graw, Mario Menk
Summary: Intracranial hemorrhage is a serious complication in patients receiving venovenous extracorporeal membrane oxygenation during treatment of the acute respiratory distress syndrome. The study found that early occurrence of intracranial hemorrhage is associated with higher 60-day mortality, and adjusting modifiable risk factors may lower the prevalence of this complication.
CRITICAL CARE MEDICINE
(2021)
Review
Critical Care Medicine
Kollengode Ramanathan, Kiran Shekar, Ryan Ruiyang Ling, Ryan P. Barbaro, Suei Nee Wong, Chuen Seng Tan, Bram Rochwerg, Shannon M. Fernando, Shinhiro Takeda, Graeme MacLaren, Eddy Fan, Daniel Brodie
Summary: A systematic review and meta-analysis of ECMO use in COVID-19 patients with ARDS found venovenous ECMO to be the predominant mode, with age and duration of ECMO support associated with increased mortality. In-hospital mortality for COVID-19 patients receiving ECMO during the first year of the pandemic was 37.1%. Efficacy of venovenous ECMO in selected COVID-19 patients with ARDS was highlighted.
Article
Cardiac & Cardiovascular Systems
Jeffrey P. Jacobs, Alfred H. Stammers, James D. St. Louis, Eric A. Tesdahl, J. W. Awori Hayanga, Rohinton J. Morris, Raymond C. Lee, Anthony K. Sestokas, Vinay Badhwar, Samuel Weinstein
Summary: This study reviewed 594 consecutive patients with COVID-19 supported with extracorporeal membrane oxygenation (ECMO) at 49 hospitals in 21 states. The study examined patient characteristics, treatments, and outcomes during different stages of the pandemic. The study found that survival for COVID-19 patients on ECMO fluctuated over the course of the pandemic, highlighting the importance of minimizing variability and following best practices in ECMO use during a pandemic response.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Medicine, General & Internal
Kevin Pilarczyk, Katharina Huenges, Burkhard Bewig, Lorenz Balke, Jochen Cremer, Assad Haneya, Bernd Panholzer
Summary: AKI is a common complication in adult patients receiving ECMO support, with two-thirds of patients experiencing moderate to severe AKI and increased morbidity and long-term mortality.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Critical Care Medicine
Ryan M. Rivosecchi, Aris R. Arakelians, John Ryan, Holt Murray, Raj Ramanan, Hernando Gomez, Dennis Phillips, Christopher Sciortino, Peter Arlia, Danielle Freeman, Penny L. Sappington, Pablo G. Sanchez
Summary: Comparison of patients receiving unfractionated heparin or bivalirudin for anticoagulation on venovenous extracorporeal membrane oxygenation revealed that those receiving bivalirudin experienced a decrease in extracorporeal membrane oxygenation circuit-related thrombotic events and reduced volume of blood products administered.
CRITICAL CARE MEDICINE
(2021)