Omicron driven ECMO in a vaccinated critically ill patient
Perfusion
; 38(1 Supplement):136-137, 2023.
Artículo
en Inglés
| EMBASE | ID: covidwho-20242110
ABSTRACT
Objectives:
Reporting a case of a COVID-19 vaccinated patient admitted to our intensive care unit with severe acute respiratory failure due to SARSCoV2 - Omicron variant, rapidly deteriorating requiring intubation, prone ventilation, and ECMO support. Method(s) A 62 years old Caucasian male was admitted in ICU for rapidly deranging respiratory failure and fever which occurred over the previous 24h. The patient received two doses of SARS-CoV2 vaccine (Oxford, AstraZeneca), the last one over five months before onset of symptoms. The patient was admitted to the intensive care unit (ICU) with tachypnea, low peripheral saturation (80%), elevated serum creatinine (2.4 mg/dl), and mild obesity (BMI 34,6). Pressure support ventilation trial (2 hours) failed carryng out to orotracheal intubation and protective ventilation. Worsening of respiratory exchanges (5 th day from the admission) required a rescue prone ventilation cycle, in the meantime an indication was given to the placement of veno-venous ECMO. The cannulation site was femoro-femoral and the configuration used was Vivc25- Va21, according to the current ELSO nomenclature;ECMO flow was progressively increased until a peripheral saturation of 95% was obtained. Result(s) The patient passed out after 2 month of extracorporeal support with no sign of recovery of pulmonary and renal function. Conclusion(s) Unlike evidences showing a lower symptomatic engagement of the Omicron variant SARSCoV2 positive patients, we have witnessed a rapid and massive pulmonary involvement. The short time that passed from the onset of symptoms and the rapid decay of respiratory function required rapid escalation of the intensity of care up to extracorporeal support. The patient showed previous pathologies that can lead to suspicion of a loss of immune coverage given by the vaccine, in addition to the long time elapsed since the last dose. (Figure Presented).
acute respiratory failure; adult; body mass; cannulation; case report; Caucasian; clinical article; conference abstract; coronavirus disease 2019; creatinine blood level; critically ill patient; drug therapy; endotracheal intubation; extracorporeal oxygenation; female; fever; human; human tissue; intensive care unit; kidney function; lung gas exchange; male; middle aged; nomenclature; nonhuman; obesity; pressure support ventilation; prone ventilation; protective ventilation; respiratory failure; respiratory function; SARS-CoV-2 Omicron; tachypnea; vaccinee; veno-venous ECMO; SARS-CoV-2 vaccine
Texto completo:
Disponible
Colección:
Bases de datos de organismos internacionales
Base de datos:
EMBASE
Tipo de estudio:
Ensayo controlado aleatorizado
Tópicos:
Covid persistente
/
Vacunas
/
Variantes
Idioma:
Inglés
Revista:
Perfusion
Año:
2023
Tipo del documento:
Artículo
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