tetano
Editor, Senior Moderator
J Card Surg. 2020 Apr 25. doi: 10.1111/jocs.14583. [Epub ahead of print]
The role of extracorporeal life support for patients with COVID-19: Preliminary results from a statewide experience.
Sultan I[SUP]1,[/SUP][SUP]2[/SUP], Habertheuer A[SUP]1[/SUP], Usman AA[SUP]3[/SUP], Kilic A[SUP]1[/SUP], Gnall E[SUP]4[/SUP], Friscia ME[SUP]5[/SUP], Zubkus D[SUP]6[/SUP], Hirose H[SUP]7[/SUP], Sanchez P[SUP]1[/SUP], Okusanya O[SUP]1[/SUP], Szeto WY[SUP]3[/SUP], Gutsche J[SUP]8[/SUP].
Author information
Abstract
OBJECTIVE:
There is a paucity of clinical data on critically ill patients with COVID-19 requiring extracorporeal life support.
METHODS:
A statewide multi-institutional collaborative for COVID-19 patients was utilized to obtain clinical data on the first 10 critically ill COVID-19 patients who required extracorporeal membrane oxygenation (ECMO).
RESULTS:
Of the first 10 patients that required ECMO for COVID-19, the age ranged from 31 to 62 years with the majority (70%) being men. Seven (70%) had comorbidities. The majority (80%) of patients had known sick contact and exposure to COVID-19 positive patients or traveled to pandemic areas inside the United States within the 2 weeks before symptom onset. None of the patients were healthcare workers. The most common symptoms leading to the presentation were high fever ≥103?F (90%), cough (80%) and dyspnea (70%), followed by fatigue and gastrointestinal symptoms (both 30%), myalgia, loss of taste, pleuritic chest pain, and confusion (all 10%). All patients had bilateral infiltrates on chest X-rays suggestive of interstitial viral pneumonia. All patients were cannulated in the venovenous configuration. Two (20%) patients were successfully liberated from ECMO support after 7 and 10 days, respectively, and one (10%) patient is currently on a weaning course. One patient (10%) died after 9 days on ECMO from multiorgan dysfunction.
CONCLUSIONS:
These preliminary multi-institutional data from a statewide collaborative offer insight into the clinical characteristics of the first 10 patients requiring ECMO for COVID-19 and their initial clinical course. Greater morbidity and mortality is likely to be seen in these critically ill patients with longer follow-up.
? 2020 Wiley Periodicals, Inc.
KEYWORDS:
COVID-19; ECMO; cardiogenic shock; coronavirus
PMID:32333431DOI:10.1111/jocs.14583
The role of extracorporeal life support for patients with COVID-19: Preliminary results from a statewide experience.
Sultan I[SUP]1,[/SUP][SUP]2[/SUP], Habertheuer A[SUP]1[/SUP], Usman AA[SUP]3[/SUP], Kilic A[SUP]1[/SUP], Gnall E[SUP]4[/SUP], Friscia ME[SUP]5[/SUP], Zubkus D[SUP]6[/SUP], Hirose H[SUP]7[/SUP], Sanchez P[SUP]1[/SUP], Okusanya O[SUP]1[/SUP], Szeto WY[SUP]3[/SUP], Gutsche J[SUP]8[/SUP].
Author information
Abstract
OBJECTIVE:
There is a paucity of clinical data on critically ill patients with COVID-19 requiring extracorporeal life support.
METHODS:
A statewide multi-institutional collaborative for COVID-19 patients was utilized to obtain clinical data on the first 10 critically ill COVID-19 patients who required extracorporeal membrane oxygenation (ECMO).
RESULTS:
Of the first 10 patients that required ECMO for COVID-19, the age ranged from 31 to 62 years with the majority (70%) being men. Seven (70%) had comorbidities. The majority (80%) of patients had known sick contact and exposure to COVID-19 positive patients or traveled to pandemic areas inside the United States within the 2 weeks before symptom onset. None of the patients were healthcare workers. The most common symptoms leading to the presentation were high fever ≥103?F (90%), cough (80%) and dyspnea (70%), followed by fatigue and gastrointestinal symptoms (both 30%), myalgia, loss of taste, pleuritic chest pain, and confusion (all 10%). All patients had bilateral infiltrates on chest X-rays suggestive of interstitial viral pneumonia. All patients were cannulated in the venovenous configuration. Two (20%) patients were successfully liberated from ECMO support after 7 and 10 days, respectively, and one (10%) patient is currently on a weaning course. One patient (10%) died after 9 days on ECMO from multiorgan dysfunction.
CONCLUSIONS:
These preliminary multi-institutional data from a statewide collaborative offer insight into the clinical characteristics of the first 10 patients requiring ECMO for COVID-19 and their initial clinical course. Greater morbidity and mortality is likely to be seen in these critically ill patients with longer follow-up.
? 2020 Wiley Periodicals, Inc.
KEYWORDS:
COVID-19; ECMO; cardiogenic shock; coronavirus
PMID:32333431DOI:10.1111/jocs.14583