Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is an established rescue therapy in the management of refractory acute respiratory distress syndrome (ARDS). Although ECMO played an important role in previous respiratory viral epidemics, concerns about the benefits and usefulness of this tec...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Journal of Intensive Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X22000949 |
| _version_ | 1797947078791397376 |
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| author | Benjamin Assouline Alain Combes Matthieu Schmidt |
| author_facet | Benjamin Assouline Alain Combes Matthieu Schmidt |
| author_sort | Benjamin Assouline |
| collection | DOAJ |
| description | Venovenous extracorporeal membrane oxygenation (VV-ECMO) is an established rescue therapy in the management of refractory acute respiratory distress syndrome (ARDS). Although ECMO played an important role in previous respiratory viral epidemics, concerns about the benefits and usefulness of this technique were raised during the coronavirus disease 2019 (COVID-19) pandemic. Indeed, the mortality rate initially reported in small case series from China was concerning and exceeded 90%. A few months later, the critical care community published the findings from several observational cohorts on the use of extracorporeal membrane oxygenation (ECMO) in COVID-19-related ARDS. Contrary to the preliminary results, data from the first surge supported the use of ECMO in experienced centers because the mortality rate was comparable to those from the ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) trial or other large prospective studies. However, the mortality rate of the population with severe disease evolved during the pandemic, in conjunction with changes in the management of the disease and the occurrence of new variants. The results from subsequent studies confirmed that the outcomes mainly depend on strict patient selection and center expertise. In comparison with non-COVID-related ARDS, the duration of ECMO for COVID-related ARDS was longer and increased over time. Clinicians and decision-makers must integrate this finding in the ECMO decision-making process to plan their ICU capacity and resource allocation. This narrative review summarizes the current evidence and specific considerations for ECMO use in COVID-19-associated ARDS. |
| first_indexed | 2024-04-10T21:21:05Z |
| format | Article |
| id | doaj.art-c61bfd36f87043f7a9ab96456b95ffff |
| institution | Directory Open Access Journal |
| issn | 2667-100X |
| language | English |
| last_indexed | 2024-04-10T21:21:05Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj.art-c61bfd36f87043f7a9ab96456b95ffff2023-01-20T04:26:16ZengElsevierJournal of Intensive Medicine2667-100X2023-01-0131410Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative reviewBenjamin Assouline0Alain Combes1Matthieu Schmidt2Médecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Paris 75013, FranceMédecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Paris 75013, France; INSERM, UMRS 1166, ICAN Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris 75013, FranceMédecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Paris 75013, France; INSERM, UMRS 1166, ICAN Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris 75013, France; Corresponding author: Matthieu Schmidt, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, 47-83 Boulevard de l'Hôpital, Paris 75013, France.Venovenous extracorporeal membrane oxygenation (VV-ECMO) is an established rescue therapy in the management of refractory acute respiratory distress syndrome (ARDS). Although ECMO played an important role in previous respiratory viral epidemics, concerns about the benefits and usefulness of this technique were raised during the coronavirus disease 2019 (COVID-19) pandemic. Indeed, the mortality rate initially reported in small case series from China was concerning and exceeded 90%. A few months later, the critical care community published the findings from several observational cohorts on the use of extracorporeal membrane oxygenation (ECMO) in COVID-19-related ARDS. Contrary to the preliminary results, data from the first surge supported the use of ECMO in experienced centers because the mortality rate was comparable to those from the ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) trial or other large prospective studies. However, the mortality rate of the population with severe disease evolved during the pandemic, in conjunction with changes in the management of the disease and the occurrence of new variants. The results from subsequent studies confirmed that the outcomes mainly depend on strict patient selection and center expertise. In comparison with non-COVID-related ARDS, the duration of ECMO for COVID-related ARDS was longer and increased over time. Clinicians and decision-makers must integrate this finding in the ECMO decision-making process to plan their ICU capacity and resource allocation. This narrative review summarizes the current evidence and specific considerations for ECMO use in COVID-19-associated ARDS.http://www.sciencedirect.com/science/article/pii/S2667100X22000949Extracorporeal membrane oxygenation (ECMO)Acute respiratory distress syndrome (ARDS)COVID-19Mortality |
| spellingShingle | Benjamin Assouline Alain Combes Matthieu Schmidt Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review Journal of Intensive Medicine Extracorporeal membrane oxygenation (ECMO) Acute respiratory distress syndrome (ARDS) COVID-19 Mortality |
| title | Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review |
| title_full | Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review |
| title_fullStr | Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review |
| title_full_unstemmed | Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review |
| title_short | Extracorporeal membrane oxygenation in COVID-19 associated acute respiratory distress syndrome: A narrative review |
| title_sort | extracorporeal membrane oxygenation in covid 19 associated acute respiratory distress syndrome a narrative review |
| topic | Extracorporeal membrane oxygenation (ECMO) Acute respiratory distress syndrome (ARDS) COVID-19 Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X22000949 |
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