Fit-for-Future: Lessons Learned from the COVID-19 Pandemic in Primary Extracorporeal Membrane Oxygenation (ECMO) Transports of Acute Respiratory Distress Syndrome (ARDS) Patients.

Fit-for-Future: Lessons Learned from the COVID-19 Pandemic in Primary Extracorporeal Membrane Oxygenation (ECMO) Transports of Acute Respiratory Distress Syndrome (ARDS) Patients.

Publication date: Sep 12, 2024

(1) Background: The COVID-19 pandemic presented significant challenges in managing acute respiratory distress syndrome (ARDS), with extracorporeal membrane oxygenation (ECMO) being a critical but resource-intensive intervention. (2) Methods: This retrospective study analyzed veno-venous (VV) ECMO therapy in ARDS patients before and during the pandemic at a high-volume ECMO center in Germany. The study used a reduced ECMO team (one medical and one nursing specialist) to optimize patient care with limited resources, aiming to offer insights for future pandemic management. Data from 181 adult patients (age ≥ 18) with severe ARDS were analyzed: 57 pre-pandemic and 124 during the pandemic. (3) Results: Despite increased isolation measures during the pandemic (25% pre-COVID-19 vs. 79% during COVID-19, p < 0. 0001), there was no significant change in transportation mode (ground vs. air) or ECMO implantation times at local hospitals. Similarly, time and distance for primary ECMO transport remained unchanged between the two periods. Complication rates related to ECMO circuit placement and prolonged transport were also insignificant across groups. However, ECMO therapy duration (median 12 days pre-COVID-19 vs. 19 days during COVID-19, p < 0. 0001) and hospital stays (median 3 days pre-COVID-19 vs. 7 days during COVID-19, p < 0. 01) were longer during the pandemic. Mortality rates were also higher during the pandemic (49% pre-COVID-19 vs. 65% during COVID-19, p < 0. 05). (4) Conclusions: In conclusion, a reduced ECMO team proved to be an effective resource-saving strategy that maintained high-quality care with low complication rates, despite the additional challenges posed by pandemic-related isolation measures.

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Concepts Keywords
Covid ARDS
Future COVID-19
Germany interhospital transfer
Nursing mortality
Pandemic primary ECMO transport
VV ECMO

Semantics

Type Source Name
disease MESH COVID-19 Pandemic
disease MESH Acute Respiratory Distress Syndrome
disease IDO intervention
drug DRUGBANK Medical air
disease IDO quality
drug DRUGBANK Ilex paraguariensis leaf
drug DRUGBANK Coenzyme M
disease MESH influenza
disease MESH complications
disease MESH sepsis
disease MESH septic shock
disease MESH infection
disease IDO site
disease IDO blood
disease MESH hypercapnia
disease MESH Emergency
disease MESH critically ill
drug DRUGBANK Sulodexide
drug DRUGBANK Oxygen
disease MESH bleeding
drug DRUGBANK Aspartame
disease MESH communication barriers
disease MESH Clinical importance
disease MESH Sequential Organ Failure Assessment Score
disease MESH Comorbidity
drug DRUGBANK Trestolone
drug DRUGBANK Midazolam
drug DRUGBANK Etoperidone
disease MESH Respiratory Failure
drug DRUGBANK Vorinostat
drug DRUGBANK Guanosine
drug DRUGBANK (S)-Des-Me-Ampa

Original Article

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