Extracorporeal life support in COVID‐19‐related acute respiratory distress syndrome: A EuroELSO international survey

Autor: Mang, Sebastian, Kalenka, Armin, Broman, Lars Mikael, Supady, Alexander, Swol, Justyna, Danziger, Guy, Becker, André, Hörsch, Sabrina, Mertke, Thilo, Kaiser, Ralf, Bracht, Hendrik, Zotzmann, Viviane, Seiler, Frederik, Bals, Robert, Taccone, Fabio Silvio, Moerer, Onnen, Lorusso, Roberto, Bělohlávek, Jan, Muellenbach, Ralf, Lepper, Philipp, Barrett, Nicholas, Duerschmied, Daniel, Fan, Eddy, Fichtner, Falk, Haake, Hendrik, Langer, Frank, Mutlak, Haitham, Kredel, Markus, Müller, Thomas, Protti, Alessandro, Raddatz, Alexander, Spangenberg, Tobias, Staudacher, Dawid, Wehrfritz, Holger, Wengenmayer, Tobias, Westheider, Arne, Dang Van, Simon, Daubin, Cedric, Gaudard, Philippe, Godet, Thomas, Guinot, Pierre‐Grégoire, Le Guennec, Loïc, Megarbane, Bruno, Mercat, Alain, Sonneville, Romain, Zogheib, Elie, Pham, Tai, Winiszewski, Hadrien, Schellongowski, Peter, Staudinger, Thomas, Wiedemann, Dominik, Velik‐Salchner, Corinna, Joannidis, Michael, Bodenstein, Marc, Groesdonk, Heinrich Volker, Guth, Stefan, Hecker, Matthias, Husain‐Syed, Faeq, Jung, Christian, Napp, L. Christian, Natanov, Ruslan, Trummer, Georg, Treskatsch, Sascha, Welp, Henryk, Avalli, Leonello, Ball, Lorenzo, Belliato, Mirko, Bonizzoli, Manuela, Borrelli, Emma, Cavallaro, Giacomo, Franci, Andrea, Gramaticopolo, Silvia, Panigada, Mauro, Tritapepe, Luigi, Abdulaziz, Salman, Bracco, David, Alexandros, Yiorgos, Joffe, Ari, Nagpal, A. Dave, Sia, Ying, Auzinger, Georg, Zochios, Vasileios, Garcia, Alejandro, Gist, Katja, Lustbader, Dana, Yannopoulos, Demetris, Stephens, R. Scott, Tonna, Joseph, Paxton, Linda, Hirose, Hitoshi, Kim, Bo, Dalén, Magnus, Balik, Martin, Janak, David, Castillo, Luis, Bruhn, Alejandro, Socarras, Jorge Luis Alvarado, Kim, Taeyun, Kim, Hyoung Soo, Byun, Joung Hun, Mainardi, Guilherme, Mendes, Pedro, Giraud, Raphaël, Fortuna, Philip, Fukuda, Tatsuma, Maas, Jacinta, Maciejewski, Dariusz, Pandit, Deblal, Psz, Yosv, Radsel, Peter, YAN, Gangfeng
Přispěvatelé: Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), MORNET, Dominique
Jazyk: angličtina
Rok vydání: 2021
Předmět:
ARDS
Internationality
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Medicine (miscellaneous)
02 engineering and technology
030204 cardiovascular system & hematology
extracorporeal life support
SARS‐CoV‐2
Hypoxemia
0302 clinical medicine
Surveys and Questionnaires
Practice Patterns
Physicians'
ComputingMilieux_MISCELLANEOUS
Respiratory Distress Syndrome
General Medicine
COVID‐19‐induced acute respiratory distress syndrome
3. Good health
[SDV] Life Sciences [q-bio]
SURVIVAL
medicine.symptom
Respiratory Insufficiency
endocrine system
medicine.medical_specialty
Critical Illness
0206 medical engineering
Biomedical Engineering
Bioengineering
Extracorporeal
Biomaterials
03 medical and health sciences
Main Text Articles
COVID‐19
medicine
Extracorporeal membrane oxygenation
Humans
survey
Main Text Article
business.industry
SARS-CoV-2
COVID-19-induced acute respiratory distress syndrome
MEMBRANE-OXYGENATION
COVID-19
extracorporeal membrane oxygenation
medicine.disease
020601 biomedical engineering
Triage
Discontinuation
Heart failure
Life support
Emergency medicine
business
Zdroj: Artificial Organs
Artificial Organs, Wiley, 2021, 45 (5), pp.495-505. ⟨10.1111/aor.13940⟩
Artificial Organs, 45(5), 495-505. Wiley
Artificial Organs, 2021, 45 (5), pp.495-505. ⟨10.1111/aor.13940⟩
ISSN: 0160-564X
1525-1594
Popis: Extracorporeal life support (ECLS) is a means to support patients with acute respiratory failure. Initially, recommendations to treat severe cases of pandemic coronavirus disease 2019 (COVID‐19) with ECLS have been restrained. In the meantime, ECLS has been shown to produce similar outcomes in patients with severe COVID‐19 compared to existing data on ARDS mortality. We performed an international email survey to assess how ECLS providers worldwide have previously used ECLS during the treatment of critically ill patients with COVID‐19. A questionnaire with 45 questions (covering, e.g., indication, technical aspects, benefit, and reasons for treatment discontinuation), mostly multiple choice, was distributed by email to ECLS centers. The survey was approved by the European branch of the Extracorporeal Life Support Organization (ELSO); 276 ECMO professionals from 98 centers in 30 different countries on four continents reported that they employed ECMO for very severe COVID‐19 cases, mostly in veno‐venous configuration (87%). The most common reason to establish ECLS was isolated hypoxemic respiratory failure (50%), followed by a combination of hypoxemia and hypercapnia (39%). Only a small fraction of patients required veno‐arterial cannulation due to heart failure (3%). Time on ECLS varied between less than 2 and more than 4 weeks. The main reason to discontinue ECLS treatment prior to patient’s recovery was lack of clinical improvement (53%), followed by major bleeding, mostly intracranially (13%). Only 4% of respondents reported that triage situations, lack of staff or lack of oxygenators, were responsible for discontinuation of ECLS support. Most ECLS physicians (51%, IQR 30%) agreed that patients with COVID‐19‐induced ARDS (CARDS) benefitted from ECLS. Overall mortality of COVID‐19 patients on ECLS was estimated to be about 55%. ECLS has been utilized successfully during the COVID‐19 pandemic to stabilize CARDS patients in hypoxemic or hypercapnic lung failure. Age and multimorbidity limited the use of ECLS. Triage situations were rarely a concern. ECLS providers stated that patients with severe COVID‐19 benefitted from ECLS.
276 ECMO professionals from 98 centers worldwide participated in this EuroELSO‐associated online survey investigating the use of ECMO for severe COVID‐19. Extracorporeal life support (ECLS) for severe COVID‐19 was used predominantly in veno‐venous configuration (87%) to treat isolated hypoxic respiratory failure (50%). Age and multimorbidity limited the use of ECLS. Overall mortality of COVID‐19 patients on ECLS was estimated to be about 55%.
Databáze: OpenAIRE
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