Lessons Learned From Extracorporeal Life Support Practice and Outcomes During the COVID-19 Pandemic

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-10-29 DOI:10.1111/ctr.15482

George Gill, Michael O'Connor, Mark E. Nunnally, Alain Combes, Michael Harper, David Baran, Mary Avila, Barbara Pisani, Hannah Copeland, Michael Nurok

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引用次数: 0

Abstract

Extracorporeal membrane oxygenation is increasingly being used to support patients with hypoxemic respiratory failure and cardiogenic shock. During the COVID-19 pandemic, consensus guidance recommended extracorporeal life support for patients with COVID-19-related cardiopulmonary disease refractory to optimal conventional therapy, prompting a substantial expansion in the use of this support modality. Extracorporeal membrane oxygenation was particularly integral to the bridging of COVID-19 patients to heart or lung transplantation. Limited human and physical resources precluded widespread utilization of mechanical support during the COVID-19 pandemic, necessitating careful patient selection and optimal management by expert healthcare teams for judicious extracorporeal membrane oxygenation use. This review outlines the evidence supporting the use of extracorporeal life support in COVID-19, describes the practice and outcomes of extracorporeal membrane oxygenation for COVID-19-related respiratory failure and cardiogenic shock, and proposes lessons learned for the implementation of extracorporeal membrane oxygenation as a bridge to transplantation in future public health emergencies.

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从 COVID-19 大流行期间的体外生命支持实践和成果中汲取的经验教训。

体外膜肺氧合越来越多地用于支持低氧性呼吸衰竭和心源性休克患者。在 COVID-19 大流行期间，共识指南建议对常规疗法难以奏效的 COVID-19 相关心肺疾病患者进行体外生命支持，促使这种支持方式的使用范围大幅扩大。体外膜肺氧合尤其是为 COVID-19 患者提供心脏或肺移植的桥梁不可或缺。由于人力和物力资源有限，在 COVID-19 大流行期间无法广泛使用机械支持，因此需要专家医疗团队对患者进行仔细选择和优化管理，以明智地使用体外膜肺氧合。本综述概述了支持在 COVID-19 中使用体外生命支持的证据，描述了体外膜肺氧合治疗 COVID-19 相关呼吸衰竭和心源性休克的实践和结果，并提出了在未来公共卫生突发事件中实施体外膜肺氧合作为移植桥梁的经验教训。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.