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Does adding mechanical circulatory support to extracorporeal membrane oxygenation (ECMO) lead to better outcomes than ECMO alone? This Concise Critical Appraisal reviews a recent meta-analysis that compares ECMO with mechanical circulatory support to ECMO alone to determine whether one group had decreased mortality and increased likelihood of good neurologic outcomes.
This Concise Critical Appraisal explores a meta-analysis showing that prone positioning is beneficial for patients meeting criteria for venovenous extracorporeal membrane oxygenation (ECMO), especially when initiated within five days after ECMO initiation. When initiated within five days, patients had lower intensive care unit (ICU) mortality rates, higher likelihood of being discharged alive, shorter ECMO duration, and cumulative 90-day probability of being discharged from the ICU.
From Critical Care Explorations The authors determine the factors associated with mortality in venovenous extracorporeal membrane oxygenation (V-V ECMO) patients with COVID-19 infection and provide an updated report of clinical outcomes for patients treated with V-V ECMO for COVID-19 in Minnesota.
Graeme MacLaren, MD, FCCM, is the lead author on an article published in the March Pediatric Critical Care Medicine titled, “Central Extracorporeal Membrane Oxygenation for Refractory Pediatric Septic Shock.”
Matthew Paden, MD, discusses his Pediatric Critical Care Medicine article, “Recovery of Renal Function and Survival After Continuous Renal Replacement Therapy During Extracorporeal Membrane Oxygenation.”
Margaret Parker, MD, FCCM, speaks with Heidi J. Dalton, MD, FCCM, about extracorporeal membrane oxygenation (ECMO) in pediatric critical care. Dalton provides of brief history of ECMO and discusses outcomes and complications as well as common techniques being used in these patients.
Margaret Parker, MD, MCCM, speaks with James Thomas, MD, about the article, “Extubation During Pediatric Extracorporeal Membrane Oxygenation: A Single-Center Experience,” published in Pediatric Critical Care Medicine.
Peta M.A. Alexander, MBBS, FRACP, FCICM, will present the Max Harry Weil Memorial Lecture titled, “What Has COVID-19 Taught Us About ECMO?” during SCCM’s 2022 Critical Care Congress.
During this webinar, experts will address questions related to caring for mechanically ventilated pregnant patients with COVID-19. Review the safety of extracorporeal membrane oxygenation in pregnancy, drug safety for critically ill patients with COVID-19, vaccination strategies, and post-ICU care for unvaccinated pregnant patients. This webcast will also benefit non-ICU clinicians who may need to care for critically ill and injured patients.
This Concise Critical Appraisal explores an article published in Critical Care Medicine on a program at Cooper University Hospital in Camden, New Jersey, USA, that implemented a previously published successful ECMO model, in which ECMO cannulation primarily performed by cardiothoracic surgeons is transitioned to medical intensivist-led cannulation. This article is significant in advancing the role of the medical intensivist in the cannulation of patients who require ECMO.
Conventional oxygen therapy is often insufficient to meet the significant oxygen needs of a patient with COVID-19 pneumonia. Several options for providing enhanced oxygen delivery have been studied throughout the COVID-19 pandemic. This webcast held on November 10, 2021, reviewed how some of these strategies are of particular use in patients with COVID-19 who have profound hypoxic respiratory failure.
From Critical Care Medicine. In this Clinical Investigation the authors investigated the impact of prone positioning during venovenous extracorporeal membrane oxygenation support for coronavirus disease 2019 acute respiratory failure on the patient outcome.
From Critical Care Medicine. In this Clinical Investigation the authors conducted a multicenter study using whole-body CT to examine the prevalence, severity, and nature of vascular complications in coronavirus disease 2019 in comparison with patients with other viral pneumonias.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 8, 2021
From Critical Care Explorations. In this study the authors found that functional impairment was common a year following the use of extracorporeal membrane oxygenation in coronavirus disease 2019, although the majority achieved independence in daily living and about half returned to work. Long-term anxiety, depression, and post-traumatic stress disorder were common, but cognitive impairment was not.
From Critical Care Explorations. In this study, the authors conclude that argatroban, with or without aspirin, is an effective anticoagulation strategy for patients who require venovenous extracorporeal membrane oxygenation support secondary to coronavirus disease 2019.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 11, 2021
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on July 14, 2021
From Critical Care Explorations. In this study, the authors observed preserved long-term volumetric lung function with decreased diffusion capacity of lung carbon monoxide among survivors from severe coronavirus disease 2019 pneumonia treated with venovenous extracorporeal membrane oxygenation.
From Critical Care Explorations. 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.
From Critical Care Explorations. This is a case report on the use of awake extracorporeal membrane oxygenation as a “treatment” for barotrauma due to severe acute respiratory distress syndrome in a coronavirus disease 2019 patient, without the need for invasive mechanical ventilation.
From Critical Care Medicine. This Online Letter to the Editor is in response to an article by Doyle et al. entitled “A comparison of thrombosis and hemorrhage rates in patients with severe respiratory failure due to coronavirus disease 2019 and influenza requiring extracorporeal membrane oxygenation.”
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 14th, 2021
From Critical Care Medicine. The authors describe and compare rates of venous thromboembolism and hemorrhage in patients with coronavirus disease 2019 against a historic population of patients with influenza pneumonia who required extracorporeal membrane oxygenation.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on February 24, 2021
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on December 9, 2020.
From Critical Care Explorations. In this case report, the authors note that late extracorporeal membrane oxygenation may be considered in selected patients as a bridge to recovery. Further prospective studies are, however, needed.
From Critical Care Explorations. In this observational study, the authors concluded that extracorporeal membrane oxygenation retrieval can rescue young, previously healthy patients with severe coronavirus disease 2019 in whom all the conventional respiratory measures have failed and found that thrombotic and hemorrhagic complications are frequent in this cohort.
From Critical Care Explorations. In this study, the authors gathered available published resources including physicochemical and pharmacokinetic properties and suggest antiviral drug dosing adaptation for coronavirus disease 2019–infected critically ill patients receiving extracorporeal therapy.
From Critical Care Explorations. In this article, the authors describe three coronavirus disease 2019 patients suffering from acute respiratory distress syndrome under venovenous extracorporeal membrane oxygenation therapy and tight anticoagulation monitoring presenting a novel pattern of multifocal brain hemorrhage in various degrees in all cerebral and cerebellar lobes.
From Critical Care Medicine. In this Letter to the Editor, the author respond to an article by Yang et al about COVID and ECMO.
From Critical Care Medicine. In this editorial, the authors discuss the important role of extracorporeal membrane oxygenation as a rescue therapy for patients with SARS-CoV-2 pneumonia associated with severe ARDS.
From Critical Care Medicine. The authors report a 100% occurrence of venous thromboembolism in critically ill patients supported by venovenous extracorporeal membrane oxygenation for severe acute respiratory syndrome coronavirus 2-related acute respiratory distress syndrome using CT scan imaging despite a high target and close monitoring of anticoagulation.
From Critical Care Medicine. Authors write regarding article by Bohman et al "Approach to Adult Extracorporeal Membrane Oxygenation Patient Selection" and note that a formal approach to decision making is key for the appropriate use of this labori ntensive rescue therapy.
In this question and answer webcast, attendees had the opportunity to post questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also addressed. Webcast held on June 19, 2020
From Critical Care Medicine. This study aims to summarize the clinical features, ECMO characteristics, and outcomes of patients with SARS-CoV-2 pneumonia receiving ECMO. The authors conclude ECMO might be an effective salvage treatment for patients with SARS27 CoV-2 pneumonia associated with severe ARDS. Severe CO2 retention and acidosis 28 prior to ECMO indicated a poor prognosis.
From Pediatric Critical Care Medicine. The authors describe current hospital guidelines and the opinions of extracorporeal membrane oxygenation leaders at U.S. children’s hospitals concerning the use of extracorporeal membrane oxygenation for coronavirus disease 2019–positive pediatric patients.
In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues.
This Concise Critical Appraisal explores a Lancet Respiratory Medicine article by Ramanathan et al, which outlines how to plan for extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS) related to COVID-19. ECMO is a complex therapy usually restricted to specialized centers. World Health Organization guidelines suggest that carefully selected patients with ARDS may benefit. The authors explore how good planning can help during outbreaks of emerging infectious diseases.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.
This presentation is an overview of using ECMO for COVID -19 patients. This is SCCM curated COVID-19 microlearning content.
Combes et al (N Engl J Med. 2018;378:1965-1975) set out to determine whether the use of ECMO reduced mortality in patients with ARDS when defined by one of three criteria: P/F ratio < 50 mm Hg for > 3 hours, P/F ratio < 80 mm Hg for > 6 hours, or pH < 7.25 coupled with Paco2 ≥ 60 mm Hg for > 6 hours (with respiratory rate < 35 beats/min and plateau pressure ≤ 32 cm H2O).