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ASAIO Journal ; 68:140, 2022.
Article in English | EMBASE | ID: covidwho-2032190


Background: Timing of tracheostomy in COVID-19 patients supported with extracorporeal oxygenation membrane (ECMO) remains unclear. This study aims to compare the short-term outcomes in early (≤7 days from ECMO insertion) (ET) versus late (LT) tracheostomy. Methods: Charts of COVID-19 patients with tracheostomy from 2020 to 2021 were reviewed, retrospectively. Primary endpoint was in-hospital mortality. Secondary endpoints were analgesics/sedatives doses, length of treatment (LOT), and initiation of physiotherapy (PT). Results: Eight patients with ET were compared to six patients with LT. Mean age was 41.4±12.5 (ET) and 49.5±6.9 (LT) years. In both groups, 50% were male with comparable BMI. Twelve patients received venovenous (VV) and two received veno-arterial (VA) ECMO. Tracheostomy post ECMO cannulation was performed in 12 [ET:6(75%);LT:6(100%)] patients, whereas in the remaining two patients, it was performed immediately after initiation of ECMO support. Average duration of ECMO support was 48.0±21.3 (ET) than 42.2±27.0 (LT) days, P=0.34. Requirement of sedatives before [ET:6.4±4.6;LT:9.3±5.3;P=0.15] and after [ET:21.6±11.9;LT:12.2±14.0;P=0.11] along with analgesics before [ET:6.3±4.9;LT:7.0±6.5;P=0.41] and after [ET:19.0±6.9;LT:14.8±15.5;P=0.28] tracheostomy was comparable. No difference was observed in the LOT during sedatives/ analgesics dosing after tracheostomy. However, the LOT before tracheostomy was significantly longer in sedatives [ET:2.9±3.1;LT:11.8±6.2, P<0.01] and analgesics [ET:2.9±2.8;LT:9.8±3.5, P<0.01], explained by the longer interval between ECMO insertion and tracheostomy in LT group. Compared to LT, number of days from ECMO insertion to first PT session was significantly shorter in ET patients [ET:13.6±5.6;LT:26.5±4.5, P<0.01]. In-hospital mortality rate was 21.4% [ET:1(13%);LT:2(33%), P=0.33] patients with comparable ICU stay [ET:56.9±18.6;LT:50.2±26.4, P=0.30] between groups. Conclusion: Although the advantages of ET to reduce the requirement of analgesics and sedatives amongst COVID19 patients supported with ECMO were like LT group, ET was associated with early initiation of PT and improved survival.

Journal of Heart and Lung Transplantation ; 41(4):S309-S310, 2022.
Article in English | Web of Science | ID: covidwho-1848283
Journal of Heart & Lung Transplantation ; 41(4):S309-S310, 2022.
Article in English | Academic Search Complete | ID: covidwho-1783360


Lung transplant is considered a last resource surgical therapy for non-resolving COVID-19-associated acute distress respiratory syndrome (ARDS) and refractory hypoxemia. Google trends (GT) is an ongoing-developing web-kit providing feedback on specific general population's interests. This study uses GT to analyze the United States (US) general population interest in LT as COVD-19/ARDS salvage therapy. GT was used to access data searched for the term lung transplant. The gathered information included data from January 2016 through October 2021 within US territories. Search frequency, time intervals, sub-regions, frequent topics of interest, and related searches were analyzed. Data was reported as search frequency on means, and a value of 100 represented overall peak popularity. The number of Google searches related to the term lung transplant has remained steady interest over time and surged in congruence with the appearance of COVID-19 in the US. From January 2016 until February 2019, interest has ranged from 29 to 58% (average 40%). Following the COVID-19 surge, average interest shifted up to 49%, with an all-time increase in November 2019, February 2020, and June 2020, of 90, 65 and 100%. Over time, the lead frequency of searches in sub-regions, metro areas, and cities, were Pennsylvania, Gainesville, FL, and Philadelphia, PA, respectively. Top related topic and top related query in search frequency, over time are electronic cigarette and lung transplant covid. At a glance, medical-relevant websites fail to provide adequate information for LT patient therapeutic education (PTE). GT complements the understanding of interest in LT, especially in consideration of the COVID-19 pandemic's perspective. When properly interpreted, the use of these trends can potentially improve on PTE and therapy awareness via specific medical relevant websites. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)