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Extracorporeal Membrane Oxygenation during Respiratory Pandemics: Past, Present, and Future.
Brodie, Daniel; Abrams, Darryl; MacLaren, Graeme; Brown, Crystal E; Evans, Laura; Barbaro, Ryan P; Calfee, Carolyn S; Hough, Catherine L; Fowles, Jo-Anne; Karagiannidis, Christian; Slutsky, Arthur S; Combes, Alain.
  • Brodie D; Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, New York.
  • Abrams D; Center for Acute Respiratory Failure, Columbia University Medical Center, New York, New York.
  • MacLaren G; Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, New York.
  • Brown CE; Center for Acute Respiratory Failure, Columbia University Medical Center, New York, New York.
  • Evans L; Cardiothoracic Intensive Care Unit, Department of Cardiac, Thoracic, and Vascular Surgery, National University Health System, Singapore, Singapore.
  • Barbaro RP; Division of Pulmonary, Critical Care, and Sleep Medicine, Harborview Medical Center, and.
  • Calfee CS; Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington.
  • Hough CL; Division of Pediatric Critical Care Medicine, University of Michigan, Ann Arbor, Michigan.
  • Fowles JA; Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, California.
  • Karagiannidis C; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, Oregon.
  • Slutsky AS; Intensive Care, Division of Surgery, Transplant and Anaesthetics, Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom.
  • Combes A; ARDS and ECMO Center Cologne-Merheim, Witten/Herdecke University, Cologne, Germany.
Am J Respir Crit Care Med ; 205(12): 1382-1390, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-1892012
ABSTRACT
The role of extracorporeal membrane oxygenation (ECMO) in the management of severe acute respiratory failure, including acute respiratory distress syndrome, has become better defined in recent years in light of emerging high-quality evidence and technological advances. Use of ECMO has consequently increased throughout many parts of the world. The coronavirus disease (COVID-19) pandemic, however, has highlighted deficiencies in organizational capacity, research capability, knowledge sharing, and resource use. Although governments, medical societies, hospital systems, and clinicians were collectively unprepared for the scope of this pandemic, the use of ECMO, a highly resource-intensive and specialized form of life support, presented specific logistical and ethical challenges. As the pandemic has evolved, there has been greater collaboration in the use of ECMO across centers and regions, together with more robust data reporting through international registries and observational studies. Nevertheless, centralization of ECMO capacity is lacking in many regions of the world, and equitable use of ECMO resources remains uneven. There are no widely available mechanisms to conduct large-scale, rigorous clinical trials in real time. In this critical care review, we outline lessons learned during COVID-19 and prior respiratory pandemics in which ECMO was used, and we describe how we might apply these lessons going forward, both during the ongoing COVID-19 pandemic and in the future.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Extracorporeal Membrane Oxygenation / COVID-19 Limits: Humans Language: English Journal: Am J Respir Crit Care Med Journal subject: Critical Care Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Extracorporeal Membrane Oxygenation / COVID-19 Limits: Humans Language: English Journal: Am J Respir Crit Care Med Journal subject: Critical Care Year: 2022 Document Type: Article