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ASAIO J ; 67(3): 250-253, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1101912


Pediatric population have been affected by the Coronavirus disease 2019 (COVID-19) to a much smaller scale compared with the adult population. The severity of the disease is variable ranging from mild form of pneumonia to severe acute respiratory distress syndrome (ARDS) that necessitates admission to the intensive care unit (ICU) requiring a maximal level of organ support. Failure of the maximum support through mechanical ventilation can lead to the consideration of a higher level of organ support through extracorporeal membrane oxygenation (ECMO). We present a case of an 8 years old girl, who presented with severe ARDS secondary to COVID-19 pneumonia for which a venovenous-ECMO (VV ECMO) was initiated. This was followed by the patient developing cardiac arrest, which was managed with extracorporeal cardiopulmonary resuscitation (ECPR). The patient was also given thrombolytic therapy during the ECPR because of high clinical suspicion for pulmonary embolism. Venovenous-arterial ECMO was then continued and the patient was successfully weaned off both VA and VV ECMO and discharged home with full neurologic recovery. This encouraging result will hopefully lead to more consideration of this lifesaving therapy for severe cardiac and respiratory failure secondary to COVID-19 in pediatric patients.

COVID-19/therapy , Cardiopulmonary Resuscitation/methods , Extracorporeal Membrane Oxygenation/methods , COVID-19/complications , Child , Female , Heart Arrest/therapy , Heart Arrest/virology , Humans , Respiratory Distress Syndrome/therapy , Respiratory Distress Syndrome/virology , Respiratory Insufficiency/therapy , Respiratory Insufficiency/virology , SARS-CoV-2
Hellenic J Cardiol ; 62(1): 24-28, 2021.
Article in English | MEDLINE | ID: covidwho-773675


The unprecedented for modern medicine pandemic caused by the SARS-COV-2 virus ("coronavirus", Covid-19 disease) creates in turn new data on the management and survival of cardiac arrest victims, but mainly on the safety of CardioPulmonary Resuscitation (CPR) providers. The Covid-19 pandemic resulted in losses of thousands of lives, and many more people were hospitalized in simple or in intensive care unit beds, both globally and locally in Greece. More specifically, in victims of cardiac arrest, both in- and out- of hospital, the increased mortality and high contagiousness of the SARS-CoV-2 virus posed new questions, of both medical and moral nature/ to CPR providers. What we all know in resuscitation, that we cannot harm the victim and therefore do the most/best we can, is no longer the everyday reality. What we need to know and incorporate into decision-making in the resuscitation process is the distribution of limited human and material resources, the potentially very poor outcome of patients with Covid-19 and cardiac arrest, and especially that a potential infection of health professionals can lead in the lack of health professionals in the near future. This review tries to incorporate the added skills and precautions for CPR providers in terms of both in- and out- hospital CPR.

COVID-19 , Cardiopulmonary Resuscitation , Heart Arrest , Occupational Health , COVID-19/mortality , COVID-19/prevention & control , COVID-19/transmission , Cardiopulmonary Resuscitation/ethics , Cardiopulmonary Resuscitation/methods , Cardiopulmonary Resuscitation/standards , Heart Arrest/therapy , Heart Arrest/virology , Humans , Occupational Exposure/prevention & control , Occupational Health/ethics , Occupational Health/standards , SARS-CoV-2