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10.1183/23120541.00463-2020

http://scihub22266oqcxt.onion/10.1183/23120541.00463-2020
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suck abstract from ncbi


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pmid33257913      ERJ+Open+Res 2020 ; 6 (4): ä
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  • Veno-venous extracorporeal membrane oxygenation in coronavirus disease 2019: a case series #MMPMID33257913
  • Zhang J; Merrick B; Correa GL; Camporota L; Retter A; Doyle A; Glover GW; Sherren PB; Tricklebank SJ; Agarwal S; Lams BE; Barrett NA; Ioannou N; Edgeworth J; Meadows CIS
  • ERJ Open Res 2020[Oct]; 6 (4): ä PMID33257913show ga
  • BACKGROUND: The use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in severe hypoxaemic respiratory failure from coronavirus disease 2019 (COVID-19) has been described, but reported utilisation and outcomes are variable, and detailed information on patient characteristics is lacking. We aim to report clinical characteristics, management and outcomes of COVID-19 patients requiring VV-ECMO, admitted over 2 months to a high-volume centre in the UK. METHODS: Patient information, including baseline characteristics and clinical parameters, was collected retrospectively from electronic health records for COVID-19 VV-ECMO admissions between 3 March and 2 May 2020. Clinical management is described. Data are reported for survivors and nonsurvivors. RESULTS: We describe 43 consecutive patients with COVID-19 who received VV-ECMO. Median age was 46 years (interquartile range 35.5-52.5) and 76.7% were male. Median time from symptom onset to VV-ECMO was 14 days (interquartile range 11-17.5). All patients underwent computed tomography imaging, revealing extensive pulmonary consolidation in 95.3%, and pulmonary embolus in 27.9%. Overall, 79.1% received immunomodulation with methylprednisolone for persistent maladaptive hyperinflammatory state. Vasopressors were used in 86%, and 44.2% received renal replacement therapy. Median duration on VV-ECMO was 13 days (interquartile range 8-20). 14 patients died (32.6%) and 29 survived (67.4%) to hospital discharge. Nonsurvivors had significantly higher d-dimer (38.2 versus 9.5 mg.L(-1), fibrinogen equivalent units; p=0.035) and creatinine (169 versus 73 mumol.L(-1); p=0.022) at commencement of VV-ECMO. CONCLUSIONS: Our data support the use of VV-ECMO in selected COVID-19 patients. The cohort was characterised by high degree of alveolar consolidation, systemic inflammation and intravascular thrombosis.
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