학술논문

Long Runs and Higher Incidence of Bleeding Complications in COVID-19 Patients Requiring Venovenous Extracorporeal Membrane Oxygenation: A Case Series from the United Arab Emirates.
Document Type
Article
Source
Indian Journal of Critical Care Medicine. Dec2021, Vol. 25 Issue 12, p1452-1458. 7p. 2 Diagrams, 3 Charts, 1 Graph.
Subject
*ADULT respiratory distress syndrome treatment
*COVID-19
*EXTRACORPOREAL membrane oxygenation
*DISEASE incidence
*ANTICOAGULANTS
*TREATMENT effectiveness
*QUALITY assurance
*DISEASE complications
*HEMORRHAGE
*HYPOXEMIA
Language
ISSN
0972-5229
Abstract
Although the pathophysiology of pulmonary disease caused by coronavirus disease-2019 (COVID-19) is not yet fully understood, successful extracorporeal membrane oxygenation (ECMO) use has been reported for COVID-19-related severe acute respiratory distress syndrome (ARDS). We report a case series of 12 patients who received long venovenous ECMO (VV ECMO) runs for refractory hypoxia (median PF ratio of 71.8, interquartile range (IQR) 53.5-78.5) from COVID-19-related ARDS. A majority (75%) of the patients were males with a median age of 44 (IQR 37-53.5). Overall, six (50%) patients survived to hospital discharge with five of them (83.3%) noted to be cerebral performance category 1 or 2 at the time of discharge. Survivors consistently showed an improvement in sequential organ failure assessment scores within 72 hours of ECMO initiation. The median ECMO duration was 28 days (IQR 13.5-50). Despite using standard anticoagulation strategy, six (50%) of our patients had one or more major bleeding episodes, which proved to be directly fatal in four (25%) patients. Although the overall outcomes of our cohort were acceptable, our patients had much longer ECMO runs (mean 38 days in survivors) and with much higher, often fatal bleeding complications. We compare our data with other published COVID-19 VV ECMO series. [ABSTRACT FROM AUTHOR]