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Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases

Identifieur interne : 000960 ( Pmc/Curation ); précédent : 000959; suivant : 000961

Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases

Auteurs : Kollengode Ramanathan [Singapour, Australie] ; David Antognini [Australie] ; Alain Combes [France] ; Matthew Paden [États-Unis] ; Bishoy Zakhary [États-Unis] ; Mark Ogino [États-Unis] ; Graeme Maclaren [Singapour, Australie] ; Daniel Brodie [États-Unis] ; Kiran Shekar [Australie]

Source :

RBID : PMC:7102637

Abstract

Summary

WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality.


Url:
DOI: 10.1016/S2213-2600(20)30121-1
PubMed: 32203711
PubMed Central: 7102637

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PMC:7102637

Le document en format XML

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<p>WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality.</p>
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<journal-id journal-id-type="nlm-ta">Lancet Respir Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Lancet Respir Med</journal-id>
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<issn pub-type="ppub">2213-2600</issn>
<issn pub-type="epub">2213-2619</issn>
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<article-id pub-id-type="pmc">7102637</article-id>
<article-id pub-id-type="publisher-id">S2213-2600(20)30121-1</article-id>
<article-id pub-id-type="doi">10.1016/S2213-2600(20)30121-1</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
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<title-group>
<article-title>Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases</article-title>
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<contrib-group>
<contrib contrib-type="author" id="au10">
<name>
<surname>Ramanathan</surname>
<given-names>Kollengode</given-names>
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<degrees>MD</degrees>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff2" ref-type="aff">b</xref>
<xref rid="aff3" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="au20">
<name>
<surname>Antognini</surname>
<given-names>David</given-names>
</name>
<degrees>MBBS</degrees>
<xref rid="aff4" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="au30">
<name>
<surname>Combes</surname>
<given-names>Alain</given-names>
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<degrees>MD</degrees>
<xref rid="aff5" ref-type="aff">e</xref>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author" id="au40">
<name>
<surname>Paden</surname>
<given-names>Matthew</given-names>
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<degrees>MD</degrees>
<xref rid="aff7" ref-type="aff">g</xref>
</contrib>
<contrib contrib-type="author" id="au50">
<name>
<surname>Zakhary</surname>
<given-names>Bishoy</given-names>
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<degrees>MD</degrees>
<xref rid="aff8" ref-type="aff">h</xref>
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<name>
<surname>Ogino</surname>
<given-names>Mark</given-names>
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<degrees>MD</degrees>
<xref rid="aff9" ref-type="aff">i</xref>
<xref rid="aff10" ref-type="aff">j</xref>
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<name>
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<given-names>Graeme</given-names>
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<degrees>MSc</degrees>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff2" ref-type="aff">b</xref>
<xref rid="aff11" ref-type="aff">k</xref>
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<name>
<surname>Brodie</surname>
<given-names>Daniel</given-names>
</name>
<degrees>MD</degrees>
<xref rid="aff12" ref-type="aff">l</xref>
<xref rid="aff13" ref-type="aff">m</xref>
<xref rid="fn1" ref-type="fn"></xref>
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<name>
<surname>Shekar</surname>
<given-names>Kiran</given-names>
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<degrees>PhD</degrees>
<email>kiran.shekar@health.qld.gov.au</email>
<xref rid="aff3" ref-type="aff">c</xref>
<xref rid="aff4" ref-type="aff">d</xref>
<xref rid="aff14" ref-type="aff">n</xref>
<xref rid="aff15" ref-type="aff">o</xref>
<xref rid="fn1" ref-type="fn"></xref>
<xref rid="cor1" ref-type="corresp">*</xref>
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</contrib-group>
<aff id="aff1">
<label>a</label>
Cardiothoracic Intensive Care Unit, National University Hospital, National University of Singapore, Singapore</aff>
<aff id="aff2">
<label>b</label>
Yong Loo Lin School of Medicine, National University of Singapore, Singapore</aff>
<aff id="aff3">
<label>c</label>
Bond University, Robina, QLD, Australia</aff>
<aff id="aff4">
<label>d</label>
University of Queensland, Brisbane, QLD, Australia</aff>
<aff id="aff5">
<label>e</label>
Institute of Cardiometabolism and Nutrition, University of Paris, Paris, France</aff>
<aff id="aff6">
<label>f</label>
Medical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France</aff>
<aff id="aff7">
<label>g</label>
Department of Pediatrics, Emory University, Atlanta, GA, USA</aff>
<aff id="aff8">
<label>h</label>
Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR, USA</aff>
<aff id="aff9">
<label>i</label>
Department of Paediatrics, Division of Neonatology, Nemours Alfred I duPont Hospital for Children, Wilmington, DE, USA</aff>
<aff id="aff10">
<label>j</label>
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA</aff>
<aff id="aff11">
<label>k</label>
Paediatric Intensive Care Unit, The Royal Children's Hospital, University of Melbourne, Melbourne, VIC, Australia</aff>
<aff id="aff12">
<label>l</label>
Columbia University College of Physicians and Surgeons, New York, NY, USA</aff>
<aff id="aff13">
<label>m</label>
Centre for Acute Respiratory Failure, New York–Presbyterian Hospital, New York, NY, USA</aff>
<aff id="aff14">
<label>n</label>
Adult Intensive Care Services, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia</aff>
<aff id="aff15">
<label>o</label>
Critical Care Research Group, Centre of Research Excellence for Advanced Cardio-respiratory Therapies Improving OrgaN Support, Brisbane, QLD, Australia</aff>
<author-notes>
<corresp id="cor1">
<label>*</label>
Correspondence to: Dr Kiran Shekar, Adult Intensive Care Services, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, QLD 4032, Australia
<email>kiran.shekar@health.qld.gov.au</email>
</corresp>
<fn id="fn1">
<label></label>
<p id="cenpara10">Joint senior authors</p>
</fn>
</author-notes>
<pub-date pub-type="pmc-release">
<day>20</day>
<month>3</month>
<year>2020</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub">
<day>20</day>
<month>3</month>
<year>2020</year>
</pub-date>
<permissions>
<copyright-statement>© 2020 Elsevier Ltd. All rights reserved.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder>Elsevier Ltd</copyright-holder>
<license>
<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<related-article related-article-type="article-reference" id="d32e583" ext-link-type="doi" xlink:href="10.1016/S2213-2600(20)30127-2"></related-article>
<abstract id="ceab10">
<title>Summary</title>
<p>WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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