Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure
OBJECTIVES:. Implantation of venovenous extracorporeal membrane oxygenation as an alternative to invasive mechanical ventilation, an “awake approach,” may facilitate a lung- and diaphragm-protective ventilatory strategies without the associated harms of endotracheal intubation, positive pressure ven...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-07-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000489 |
| _version_ | 1818733925620514816 |
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| author | Nawaporn Assanangkornchai, MD, FRCPT Douglas Slobod, MD, FRCPC Rayan Qutob, MD May Tam, CCP, CPC Jason Shahin, MD, MSc, FRCPC Gordan Samoukovic, MD, MSc, FRCSC |
| author_facet | Nawaporn Assanangkornchai, MD, FRCPT Douglas Slobod, MD, FRCPC Rayan Qutob, MD May Tam, CCP, CPC Jason Shahin, MD, MSc, FRCPC Gordan Samoukovic, MD, MSc, FRCSC |
| author_sort | Nawaporn Assanangkornchai, MD, FRCPT |
| collection | DOAJ |
| description | OBJECTIVES:. Implantation of venovenous extracorporeal membrane oxygenation as an alternative to invasive mechanical ventilation, an “awake approach,” may facilitate a lung- and diaphragm-protective ventilatory strategies without the associated harms of endotracheal intubation, positive pressure ventilation, and continuous sedation. This report presents the characteristics and outcomes of the patients treated with the awake venovenous extracorporeal membrane oxygenation approach.
DESIGN:. Retrospective case series.
SETTING:. Monocenter study.
PATIENTS:. Severe acute respiratory syndrome coronavirus 2 patients with acute respiratory failure treated with venovenous extracorporeal membrane oxygenation instead of invasive mechanical ventilation from March 2020 to March 2021.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. Physiologic and laboratory data were collected at admission to the ICU, prior to and after venovenous extracorporeal membrane oxygenation implantation, and at decannulation. Seven patients were treated with venovenous extracorporeal membrane oxygenation instead of invasive mechanical ventilation due to hypoxemia with a median Pao2/Fio2 ratio at implantation of 76 (interquartile range, 59–92). Four patients in the awake group subsequently required invasive mechanical ventilation, and only one patient (14.3%) died. There were no significant complications attributed venovenous extracorporeal membrane oxygenation.
CONCLUSIONS:. This report demonstrates that in a selected group of patients, an “awake” venovenous extracorporeal membrane oxygenation approach is feasible and may result in favorable outcomes. |
| first_indexed | 2024-12-17T23:57:13Z |
| format | Article |
| id | doaj.art-f8d97f6004d14fc3b51870fb2addce6d |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-12-17T23:57:13Z |
| publishDate | 2021-07-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-f8d97f6004d14fc3b51870fb2addce6d2022-12-21T21:28:02ZengWolters KluwerCritical Care Explorations2639-80282021-07-0137e048910.1097/CCE.0000000000000489202107000-00028Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory FailureNawaporn Assanangkornchai, MD, FRCPT0Douglas Slobod, MD, FRCPC1Rayan Qutob, MD2May Tam, CCP, CPC3Jason Shahin, MD, MSc, FRCPC4Gordan Samoukovic, MD, MSc, FRCSC51 McGill University, Montreal, QC, Canada.1 McGill University, Montreal, QC, Canada.1 McGill University, Montreal, QC, Canada.5 Perfusion Department, McGill University Health Center, Montreal, QC, Canada.3 Department of Critical Care, McGill University, Montreal, QC, Canada.3 Department of Critical Care, McGill University, Montreal, QC, Canada.OBJECTIVES:. Implantation of venovenous extracorporeal membrane oxygenation as an alternative to invasive mechanical ventilation, an “awake approach,” may facilitate a lung- and diaphragm-protective ventilatory strategies without the associated harms of endotracheal intubation, positive pressure ventilation, and continuous sedation. This report presents the characteristics and outcomes of the patients treated with the awake venovenous extracorporeal membrane oxygenation approach. DESIGN:. Retrospective case series. SETTING:. Monocenter study. PATIENTS:. Severe acute respiratory syndrome coronavirus 2 patients with acute respiratory failure treated with venovenous extracorporeal membrane oxygenation instead of invasive mechanical ventilation from March 2020 to March 2021. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Physiologic and laboratory data were collected at admission to the ICU, prior to and after venovenous extracorporeal membrane oxygenation implantation, and at decannulation. Seven patients were treated with venovenous extracorporeal membrane oxygenation instead of invasive mechanical ventilation due to hypoxemia with a median Pao2/Fio2 ratio at implantation of 76 (interquartile range, 59–92). Four patients in the awake group subsequently required invasive mechanical ventilation, and only one patient (14.3%) died. There were no significant complications attributed venovenous extracorporeal membrane oxygenation. CONCLUSIONS:. This report demonstrates that in a selected group of patients, an “awake” venovenous extracorporeal membrane oxygenation approach is feasible and may result in favorable outcomes.http://journals.lww.com/10.1097/CCE.0000000000000489 |
| spellingShingle | Nawaporn Assanangkornchai, MD, FRCPT Douglas Slobod, MD, FRCPC Rayan Qutob, MD May Tam, CCP, CPC Jason Shahin, MD, MSc, FRCPC Gordan Samoukovic, MD, MSc, FRCSC Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure Critical Care Explorations |
| title | Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure |
| title_full | Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure |
| title_fullStr | Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure |
| title_full_unstemmed | Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure |
| title_short | Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure |
| title_sort | awake venovenous extracorporeal membrane oxygenation for coronavirus disease 2019 acute respiratory failure |
| url | http://journals.lww.com/10.1097/CCE.0000000000000489 |
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