Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases.
Betacoronavirus
/ isolation & purification
COVID-19
Communicable Diseases, Emerging
/ epidemiology
Coronavirus Infections
/ epidemiology
Extracorporeal Membrane Oxygenation
/ methods
Humans
Pandemics
Pneumonia, Viral
/ epidemiology
Practice Guidelines as Topic
Respiratory Distress Syndrome
/ therapy
SARS-CoV-2
Journal
The Lancet. Respiratory medicine
ISSN: 2213-2619
Titre abrégé: Lancet Respir Med
Pays: England
ID NLM: 101605555
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
14
02
2020
revised:
27
02
2020
accepted:
05
03
2020
pubmed:
24
3
2020
medline:
15
5
2020
entrez:
24
3
2020
Statut:
ppublish
Résumé
WHO interim guidelines recommend offering extracorporeal membrane oxygenation (ECMO) to eligible patients with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The number of patients with COVID-19 infection who might develop severe ARDS that is refractory to maximal medical management and require this level of support is currently unknown. Available evidence from similar patient populations suggests that carefully selected patients with severe ARDS who do not benefit from conventional treatment might be successfully supported with venovenous ECMO. The need for ECMO is relatively low and its use is mostly restricted to specialised centres globally. Providing complex therapies such as ECMO during outbreaks of emerging infectious diseases has unique challenges. Careful planning, judicious resource allocation, and training of personnel to provide complex therapeutic interventions while adhering to strict infection control measures are all crucial components of an ECMO action plan. ECMO can be initiated in specialist centres, or patients can receive ECMO during transportation from a centre that is not specialised for this procedure to an expert ECMO centre. Ensuring that systems enable safe and coordinated movement of critically ill patients, staff, and equipment is important to improve ECMO access. ECMO preparedness for the COVID-19 pandemic is important in view of the high transmission rate of the virus and respiratory-related mortality.
Identifiants
pubmed: 32203711
pii: S2213-2600(20)30121-1
doi: 10.1016/S2213-2600(20)30121-1
pmc: PMC7102637
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
518-526Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
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