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Outcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome due to COVID-19, lessons learned from the first wave of COVID 19
  • Cameron Blazoski,
  • Michael Baram,
  • Hitoshi Hirose
Cameron Blazoski
Thomas Jefferson University Hospital

Corresponding Author:[email protected]

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Michael Baram
Thomas Jefferson University Hospital
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Hitoshi Hirose
Thomas Jefferson University Hospital
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Introduction: Extracorporeal membrane oxygenation (ECMO) has been used as a refractory treatment for acute respiratory distress syndrome (ARDS) due to COVID-19, but there has been little evidence of its efficacy. We conducted this study to share our experience using ECMO as a bridge to recovery for ARDS due to COVID-19. Methods: All adult patients who were placed on ECMO for ARDS due to COVID -19 between April 2020 and June 2020 (during the first wave of COVID-19) were identified. The clinical characteristics and outcomes of these patients were analyzed with a specific focus on the differences between patients who survived to hospital discharge and those who did not. Results: 20 COVID-19 patients were included in this study. All patients were placed on veno-veno ECMO. Comparing between survivors and non-survivors, older age was associated with hospital mortality (p=0.02). The following complications were observed: renal failure requiring renal replacement therapy (35%, n=7), bacteremia during ECMO (20%, n=4),coinfection with bacterial pneumonia (15%, n=3), cannula site bleeding (15%, n=3), stroke (10%, n=2), gastrointestinal bleeding (10%, n=2), and liver failure (5%, n=1). The complications associated with patient mortality were culture positive septic shock (p=0.01), culture-negative systemic inflammatory response syndrome (p=0.01), and renal failure (p=0.01). The causes of death were septic shock (44%, n=4), culture-negative systemic inflammatory response syndrome (44%, n=4), and stroke (11%, n=1). Conclusions: Based on our experience, ECMO can improve refractory ARDS due to COVID-19 in select patients. Proper control of bacterial infections during COVID-19 immunomodulation therapy may be critical to improving survival.
31 Dec 2020Submitted to Journal of Cardiac Surgery
02 Jan 2021Submission Checks Completed
02 Jan 2021Assigned to Editor
10 Jan 2021Review(s) Completed, Editorial Evaluation Pending
10 Jan 2021Editorial Decision: Revise Major
11 Jan 20211st Revision Received
11 Jan 2021Assigned to Editor
11 Jan 2021Submission Checks Completed
04 Feb 2021Review(s) Completed, Editorial Evaluation Pending
04 Feb 2021Editorial Decision: Revise Major
08 Feb 20212nd Revision Received
08 Feb 2021Submission Checks Completed
08 Feb 2021Assigned to Editor
08 Feb 2021Review(s) Completed, Editorial Evaluation Pending
20 Feb 2021Editorial Decision: Accept
Jul 2021Published in Journal of Cardiac Surgery volume 36 issue 7 on pages 2219-2224. 10.1111/jocs.15512