Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure.
| Title: | Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure. |
|---|---|
| Authors: | Assanangkornchai N; McGill University, Montreal, QC, Canada.; Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.; Department of Critical Care, McGill University, Montreal, QC, Canada.; Slobod D; McGill University, Montreal, QC, Canada.; Department of Critical Care, McGill University, Montreal, QC, Canada.; Qutob R; McGill University, Montreal, QC, Canada.; Department of Critical Care, McGill University, Montreal, QC, Canada.; Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.; Tam M; Perfusion Department, McGill University Health Center, Montreal, QC, Canada.; Shahin J; Department of Critical Care, McGill University, Montreal, QC, Canada.; Division of Pulmonary Medicine, Department of Internal Medicine, McGill University, Montreal, QC, Canada.; Samoukovic G; Department of Critical Care, McGill University, Montreal, QC, Canada.; Department of Surgery, McGill University, Montreal, QC, Canada. |
| Source: | Critical care explorations [Crit Care Explor] 2021 Jul 15; Vol. 3 (7), pp. e0489. Date of Electronic Publication: 2021 Jul 15 (Print Publication: 2021). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]- |
| Abstract: | 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.; (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.) |
| Competing Interests: | The authors have disclosed that they do not have any potential conflicts of interest. |
| References: | JAMA. 2019 Aug 13;322(6):557-568. (PMID: 31408142); Am J Respir Crit Care Med. 2021 Jun 15;203(12):1571-1573. (PMID: 33901416); Anesthesiology. 2017 Apr;126(4):678-687. (PMID: 28212205); Am J Respir Crit Care Med. 2012 Apr 1;185(7):763-8. (PMID: 22268135); Intensive Care Med. 2013 Nov;39(11):2056-7. (PMID: 23921981); Intensive Care Med. 2020 Apr;46(4):606-618. (PMID: 32016537); Crit Care. 2016 Jun 30;20(1):150. (PMID: 27357690); Am J Respir Crit Care Med. 2021 Jan 1;203(1):54-66. (PMID: 33119402); J Thorac Dis. 2016 Jan;8(1):37-42. (PMID: 26904210) |
| Contributed Indexing: | Keywords: acute respiratory distress syndrome; coronavirus disease 2019; mechanical ventilation; mortality; noninvasive ventilation; venovenous extracorporeal membrane oxygenation |
| Entry Date(s): | Date Created: 20210721 Latest Revision: 20210722 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8284710 |
| DOI: | 10.1097/CCE.0000000000000489 |
| PMID: | 34286281 |
| Database: | MEDLINE |
Journal Article