Extracorporeal membrane oxygenation for respiratory failure in COVID-19 patients: outcome and time-course of clinical an
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CORRESPONDENCE
Extracorporeal membrane oxygenation for respiratory failure in COVID-19 patients: outcome and time-course of clinical and biological parameters Pierre Huette, MD . Christophe Beyls, MD . Mathieu Guilbart, MD . Alexandre Coquet, MD . Pascal Berna, MD, PhD . Guillaume Haye, MD . Pierre-Alexandre Roger, MD . Patricia Besserve, MD . Michael Bernasinski, MD . Herve´ Dupont, MD, PhD . Osama Abou-Arab, MD, PhD . Yazine Mahjoub, MD, PhD Received: 24 April 2020 / Revised: 23 May 2020 / Accepted: 25 May 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, The place of extracorporeal membrane oxygenation (ECMO) therapy in the coronavirus disease 2019 (COVID19) outbreak is undefined.1 Our tertiary hospital is situated in Picardy (northern France), one of the areas most affected by the outbreak in France. We report a prospective caseseries that describes the clinical course of patients with COVID-19 with respiratory failure requiring veno-venous ECMO between March 2020 and April 2020. After ethical approval, we prospectively collected data on consecutive COVID-19 patients (confirmed with reverse transcription polymerase chain reaction testing) admitted to our referral centre for ECMO therapy. Demographic, biological, and clinical data were collected during ECMO therapy. Data on outcomes were reported. Fourteen patients were eligible for ECMO during this period; two of them died in peripheral centres during ECMO cannulation (one patient was in refractory septic shock and one patient had a massive pulmonary embolism). Twelve patients were admitted to our centre; all had
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01727-z) contains supplementary material, which is available to authorized users. P. Huette, MD (&) C. Beyls, MD M. Guilbart, MD A. Coquet, MD G. Haye, MD P.-A. Roger, MD P. Besserve, MD M. Bernasinski, MD H. Dupont, MD, PhD O. Abou-Arab, MD, PhD Y. Mahjoub, MD, PhD Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France e-mail: [email protected] P. Berna, MD, PhD Department of Thoracic Surgery, Amiens University Hospital, Amiens, France
percutaneous femoro-jugular cannulation. Patients were mainly male with a medical history of hypertension and diabetes (eTable 1 in the Electronic Supplementary Material [ESM]). Prior to ECMO, patients were severely hypoxemic with a median [interquartile range (IQR)] arterial oxygen partial pressure/fractional inspired oxygen (PaO2/FIO2) ratio of 76 [66–83] mmHg, pH of 7.31 [7.22– 7.36], and partial pressure of carbon dioxide of 55 [42–60] mmHg. In line with current data, we found a mildly impaired respiratory system compliance of 30 [27–32] mLmmHg-12 All patients were treated with inhaled nitric oxide, neuromuscular blockade, and prone positioning prior to ECMO therapy. Median [IQR] intensive care unit (ICU) length of stay before ECMO initiation was 6 [4–8] days. Median [IQR] lymphocyte count was 600 [400–1000] mm-3, fibrino
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