{"id":20380,"date":"2021-09-24T04:57:00","date_gmt":"2021-09-23T20:57:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=20380"},"modified":"2021-09-24T05:45:59","modified_gmt":"2021-09-23T21:45:59","slug":"icu-management-practice-ecmo%e6%b2%bb%e7%96%97%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=20380","title":{"rendered":"[ICU Management &#038; Practice]: ECMO\u6cbb\u7597\u65b0\u51a0\u80ba\u708e"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">ECMO for COVID-19<\/h1>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/f_auto,fl_lossy\/v1624334403\/cw\/00119258_cw_image.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<p>Extracorporeal membrane oxygenation (ECMO) has been used in patients with COVID-19 who develop severe acute respiratory distress syndrome (ARDS). ECMO has previously been used in other infectious outbreaks, including the 2009 influenza A (H1N1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak.<\/p>\n\n\n\n<p>The Extracorporeal Life Support Organisation (ELSO), the World Health Organization and the Surviving Sepsis Campaign (SSC) guidelines all recommend the use of ECMO in patients with COVID-19 related severe ARDS. However, recently updated guidelines from SSC suggest that ECMO should be considered only for carefully selected patients with COVID-19 and severe ARDS.<\/p>\n\n\n\n<p>In this systematic review and meta-analysis, researchers aimed to summarise outcome data and identify risk factors for unfavourable outcomes to guide clinical decision-making and future research. Twenty-two observational studies with 1896 patients were included in the meta-analysis. The primary outcome was in-hospital mortality, while secondary outcomes included the duration of ECMO therapy and mechanical ventilation, weaning rate from ECMO and complications during ECMO.<\/p>\n\n\n\n<p>Venovenous ECMO was the predominant mode used as per the analysis. In-hospital mortality in COVID-19 patients supported with ECMO was 37.1%. Mortality in the venovenous ECMO group was 35.7%. Both age and ECMO duration were associated with increased mortality. Duration of ECMO support as per the pooled data was 15.1 days, while weaning was accomplished in 67.6% of patients. Across the studies, a total of 1583 ECMO complications were reported, among which renal complications were most common, followed by mechanical and infectious complications.<\/p>\n\n\n\n<p>Findings from this analysis show that the majority of patients with COVID-19 ARDS received venovenous support. In-hospital mortality in patients who received ECMO was 37.1% during the first year of the pandemic. This was similar to non-COVID-19 related ARDS. Increasing age was a risk factor for death. Overall, venovenous ECMO can be considered an effective intervention in selected patients with COVID-19 ARDS.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-021-03634-1\" target=\"_blank\" rel=\"noreferrer noopener\">Critical Care<\/a><\/p>\n\n\n\n<p>Image Credit: iStock<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">References:<\/h4>\n\n\n\n<p>Ramanathan K, Shekar K, Ling RR et al. (2021)&nbsp;<a href=\"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-021-03634-1\" target=\"_blank\" rel=\"noreferrer noopener\">Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis.<\/a>&nbsp;Crit Care&nbsp;25,&nbsp;211. https:\/\/doi.org\/10.1186\/s13054-021-03634-1<\/p>\n\n\n\n<p>Published on : Tue, 22 Jun 2021<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECMO for COVID-19 Extracorporeal membrane oxygenation ( [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20380"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20380"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20380\/revisions"}],"predecessor-version":[{"id":20381,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20380\/revisions\/20381"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20380"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20380"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20380"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}