A Case Series of Black and Hispanic COVID-19 Patients Treated with ECMO
| Autor: | Alberto Sabates, Robert Chait, Renuka Reddy, Waqas Ghumman, Pradeep Dayanand, Kai Chen, C. T. Quesada, Edwin Grajeda |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty ARDS business.industry medicine.medical_treatment Deep vein Salvage therapy medicine.disease Thrombosis Pulmonary embolism medicine.anatomical_structure surgical procedures operative Internal medicine Acute care Bacteremia medicine Extracorporeal membrane oxygenation Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Heart and Lung Transplantation |
| ISSN: | 1557-3117 1053-2498 |
| Popis: | Purpose Extracorporeal Membrane Oxygenation (ECMO) has been utilized as salvage therapy in patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19. We aim to present our experience with ECMO in a community hospital for minority patients with COVID-19. Methods This is a retrospective analysis of all SARS-CoV2 infected patients who developed ARDS and received ECMO at a tertiary cardiovascular care center between March and August 2020. Patient demographics, data pre- and on-ECMO, hemodynamics, and ventilation parameters were collected. Primary outcome of interest was mortality. Secondary outcomes were length of stay, bleeding requiring transfusion, coagulopathies, infections, and procedural-related complications. Results We identified 10 COVID-19 patients with ARDS treated with ECMO. The mean age was 45 years and 70% were male. The racial composition of the patients consisted of Blacks (30%) and Hispanics (70%). Comorbidities included hypertension (40%), diabetes mellitus (50%), and hyperlipidemia (20%). Eight patients were treated with VV-ECMO, and the remaining patients with VA-ECMO. Hospital-acquired infections including ventilator-associated pneumonia and bacteremia were reported in 50% and 30%, respectively. Hemorrhage requiring transfusion was reported in all 10 patients, with 60% of patients having bleeding from a gastrointestinal source. 70% of patients developed thrombocytopenia, and 20% developed a clot within the ECMO circuit. Coagulation disorders reported, included heparin-induced thrombocytopenia (20%), deep vein thrombosis (30%), and pulmonary embolism (20%). 90% of patients died, and 1 patient was discharged to a long-term acute care hospital (See Table 1 for outcomes). Conclusion Despite using ECMO as rescue therapy, mortality among COVID-19 patients who developed ARDS remained high in minority groups. Further studies are needed to investigate management of COVID-19 related complications. |
| Databáze: | OpenAIRE |
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