| Property | Value |
|---|
|
?:abstract
|
-
INTRODUCTION: In this paper, we describe our experience and early outcomes with critically unwell severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients who required extracorporeal membrane oxygenation (ECMO). We present our standard practices around ECMO decision-making, retrieval, cannulation, ventilation, anticoagulation, tracheostomy, imaging and steroids. METHODS: A retrospective cohort study using data from the hospital notes on all SARS-CoV-2 patients who required extracorporeal support at St Bartholomew’s Hospital between 1 March 2020 and 31 July 2020. In total, this included 18 patients over this time period. RESULTS: In total, 18 patients were managed with extracorporeal support and of these 14 survived (78%) with 4 deaths (22%). The mean duration from hospital admission to intubation was 4.1 ± 3.4 days, mean time from intubation to ECMO 2.3 ± 2 days and mean run on ECMO 17.7 ± 9.4 days. Survivor mean days from intubation to extubation was 20.6 ± 9.9 days and survivor mean days from intubation to tracheostomy decannulation 46.6 ± 15.3 days. Time from hospital admission to discharge in survivors was a mean of 57.2 ± 25.8 days. Of the patients requiring extracorporeal support, the initial mode was veno-venous (VV) in 15 (83%), veno-arterial (VA) in 2 (11%) and veno-venous-arterial (VVA) in 1 (6%). On VV extracorporeal support, 2 (11%) required additional VVA. Renal replacement therapy was required in 10 (56%) of the patients. Anticoagulation target anti-Xa of 0.2–0.4 was set, with 10 (56%) patients having a deep vein thrombosis or pulmonary embolism detected and 2 (11%) patients suffering an intracranial haemorrhage. Tracheostomy was performed in 9 (50%) of the patients and high-dose methylprednisolone was given to 7 (39%) of the patients. CONCLUSION: In our cohort of patients with severe SARS-CoV-2 respiratory failure, a long period of invasive ventilation and extracorporeal support was required but achieving good outcomes despite this. There was a significant burden of thromboembolic disease and renal injury. A significant proportion of patients required tracheostomy and steroids to facilitate weaning.
|
|
is
?:annotates
of
|
|
|
?:creator
|
|
|
?:doi
|
-
10.1007/s12055-020-01084-y
|
|
?:doi
|
|
|
?:journal
|
-
Indian_J_Thorac_Cardiovasc_Surg
|
|
?:license
|
|
|
?:pdf_json_files
|
-
document_parses/pdf_json/195627feba37ca82373743510812940707c20788.json
|
|
?:pmc_json_files
|
-
document_parses/pmc_json/PMC7683277.xml.json
|
|
?:pmcid
|
|
|
?:pmid
|
|
|
?:pmid
|
|
|
?:publication_isRelatedTo_Disease
|
|
|
?:sha_id
|
|
|
?:source
|
|
|
?:title
|
-
SARS-CoV-2 and ECMO: early results and experience
|
|
?:type
|
|
|
?:year
|
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}