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Objective: This study examined the clinical consequences of pregnancy coexisting with severe acute respiratory syndrome coronavirus 2 in the intensive care unit (ICU). Materials and Methods: The study was designed as a retrospective observational study. After the ethical approval of the local ethics committee, the study was conducted for a period when the number of young coronavirus disease-2019 (COVID-19) cases increased in our country. The patients enrolled in the study were pregnant/puerperal patients followed up in our third-level ICU. Results: The mean age of 35 pregnant women included in the study was 29.57±4.36 years. Twenty-one of the births (80.8%) were preterm births. Twelve (34.3%) patients received invasive mechanical ventilation (IMV), and 5 (41.7%) of these patients were deceased. Twenty-six (74.3%) underwent a cesarean section (C/S). There were 5 (14.3%) patients who needed extracorporeal membrane oxygenation and 3 (8.5%) patients who needed continuous renal replacement therapy. The 28-day neonatal mortality rate for 26 births was 3.8%. The maternal mortality rate in the ICU was 14.3%. Conclusion: The preterm birth rate was high in our pregnant patients followed up in the ICU with a diagnosis of COVID-19. Because of clinical and radiological progression in pregnant women, it is difficult to indicate any gestational week in which maternal outcomes are better to undergo C/S. IMV mortality is not higher than in non-pregnant patients, so endotracheal intubation should not be avoided in appropriate patients, whether pregnancy continues or not. The absence of fully vaccinated patients in the study group revealed the protective effect of vaccination during pregnancy. [ABSTRACT FROM AUTHOR]

Many cardiac, pulmonary, and psychiatric complications occur due to long-term bed rest, infection, and critical illness neuropathy/myopathy in extra-corporeal membrane oxygenation (ECMO) applied coronavirus disease-2019 (COVID-19) inpatients in intensive care units. Physiotherapy plays an important role in restoring physical functions in the subacute phase following ECMO decannulation. After being discharged, and with combined rehabilitation, these patients experience a faster recovery and their quality of life increases. In this article, the effects of the combined physiotherapy program, which was applied to two patients with COVID-19 who received ECMO treatment and were discharged from the intensive care unit, is discussed. Early application of the combined rehabilitation program after discharge resulted in a positive outcome. [ABSTRACT FROM AUTHOR]

Patients who do not respond to conventional mechanical ventilation (MV) support for respiratory failure due to the Coronavirus disease-19 may require the support of extracorporeal membrane oxygenation (ECMO). Intrahospital transportation of critically ill patients under MV and ECMO support carries potential risks that could be life-threatening. A structured process performed by a professional team plays a vital role in improving patient safety during transportation of the patient. In this presentation, we aim to share our experiences during the intrahospital transportation of a patient on ECMO support with appropriate equipment and a team of experienced personel. [ABSTRACT FROM AUTHOR]

Hypercoagulopathy associated with the novel coronavirus disease (COVID-19) is the leading cause of acute respiratory distress syndrome (ARDS), multiple organ failure, and mortality. Extracorporeal membrane oxygenation (ECMO) has been used to manage patients with COVID 19-associated severe respiratory or cardiac failure. In this report, we aim to summarise our experience with deadly thrombotic complications during venovenous ECMO (vvECMO) treatment in 6 patients with COVID-19-associated ARDS between March 19, 2020 and April 20, 2020. Based on our experience with 6 COVID-19-associated ARDS patients on ECMO, we intend to raise awareness regarding thrombotic complications leading to mortality. [ABSTRACT FROM AUTHOR]

Aim: Extracorporeal membrane oxygenation (ECMO) is an important option for the management of severe acute respiratory distress syndrome (ARDS) in Coronavirus disease-2019 (COVID-19) cases. We aimed to present our experiences of ECMO in patients with respiratory failure secondary to COVID-19. Methods: Data of 22 consecutive COVID-19 patients with severe respiratory failure whom were supported with ECMO were collected from computer-based hospital software retrospectively. Patients were treated in a single medical center between April 23, 2020 and February 14, 2021. Patients were analyzed from the points of laboratory and inflammatory markers, ventilation and ECMO features. Results: The ages of patients were between 30 and 69 years (mean age: 56.3±10.63). All patients were under maximum ventilator support, with the prone position. All patients had elevated levels of inflammatory indicators as D-dimer and ferritin. The mean level of ferritin was 1,564±1,611 ng/mL. D-dimer value was maximum 10.000 mg/mL (mean: 5,215±3,104), CRP increased to 177 mg/L (mean: 159±71). Percent of lymphocytes decreased as low as 2% (mean: 4.16±2.10). The mean duration of veno-arterial (VA) ECMO was 1.6±0.94 days whereas, for veno-venous (VV) ECMO, it was 10.05±5 days. VA ECMO was decided due to cardiovascular collapse. Four patients with VA ECMO survived a maximum of 3 days. Four of (22.22%) of 18 VV ECMO supported patient's blood gas values were at normal ranges, 3 of them needed tracheostomy, and all of could be discharged from the hospital. Conclusion: Although, ECMO support for severe respiratory failure patients with COVID-19 is more challenging than regular ECMO applications, especially VV ECMO usage should be reminded as a remedy. [ABSTRACT FROM AUTHOR]

Aims: Limited data about disease management strategies are available for pediatric patients with coronavirus disease-2019, particularly in Turkey. This study aimed to share the data on patients aged under 18 years in our country to be beneficial for understanding the disease course in children. Methods: A retrospective review of the medical records of pediatric patients aged under 18 years who were confirmed as coronavirus disease-2019 between March 11, and June 23, 2020, and were admitted to our hospitals was conducted. Results: A total of 220 pediatric patients with coronavirus disease-2019 were evaluated, of which 48.2% were boys, with a median age of 10 years, and 9.5% had underlying diseases. Patients were classified according to severity, with the percentages of asymptomatic, mild, moderate, and critical/severe cases determined to be 25.5%, 45%, 26.8%, and 2.7%, respectively. Extracorporeal membrane oxygenation was required in two patients (0.9%) and mechanical ventilation in three (1.4%). Targeted therapies were used in six patients (2.7%), with hydroxychloroquine being the most commonly used agent either alone (one patient) or in combination with favipiravir (five patients). Two patients (0.9%) died, and nine (4.1%) were still hospitalized during the study period. Conclusion: Although the disease course of coronavirus disease-2019 seems to be mild in children, critical illness is significant, and the treatment strategy primarily should consist of supportive care according to our preliminary observations. [ABSTRACT FROM AUTHOR]

Introduction: The need for mechanical ventilation and mortality rates are high as a result of acute respiratory distress syndrome (ARDS) developing after COVID-19. The role of Extracorporeal Membrane Oxygenation (ECMO) supportive therapy in the COVID-19 pandemic is still unclear. In our study, we aimed to share the effectiveness of the ECMO supportive treatment, the difficulties we encountered, and our clinical experiences in 26 patients with ARDS caused by COVID-19 pneumonia in the intensive care unit of a third-level training and research hospital during the pandemic period. Materials and Methods: Patients who received ECMO support between 11.03.2020 and 01.03.2021 in the University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital were evaluated retrospectively. During the study period, ECMO supportive treatment was applied to 26 patients due to ARDS. Results: A total of 26 patients underwent V-V ECMO and 2 patients could be decannulated. Sixteen (61.5%) of the patients were male, 10 (38.5%) were female, with a mean age of 51.3 (29-71). Mean time from hospitalization to intubation was 10.1±5.9 (1-27) days, mean duration of stay on mechanical ventilator before ECMO was 9.7±7.2 (1-28) days, mean duration of stay on ECMO support was 12. It was found to be 3 (1-23) days (Table 1). Of the 26 patients who received ECMO support, 24 died. One of the surviving patients left ECMO support after 13 days and the other 16 days later. After ECMO, MV support continued for 21 days and 16 days, respectively. Surviving patients were discharged with full recovery. ECMO was terminated due to bleeding in two patients and cannula removal in two patients. Conclusion: ECMO supportive therapy is associated with high mortality in ARDS patients developing after COVID-19. However, in COVID 19 disease, ECMO is a life-saving support method when applied in the early period. The usefulness of ECMO as a rescue therapy in critically ill patients with ARDS due to COVID-19 has so far been limited and more studies are needed for its application in these patients. [ABSTRACT FROM AUTHOR]

Objective: The new coronavirus disease, in which hundreds of thousands of people are infected in the world, appears in tables ranging from asymptomatic course to severe acute respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) is one of the salvage treatments applied in intubated patients due to high mortality. We aimed to describe our experience in a COVID-19 infected pregnant woman with ECMO theraphy in our clinic. Case: A 37-year-old patient who was 34 weeks pregnant presented with a fever of 39 °C for 3 days, and a cough. Because of the appearance of bilateral ground glass on CT, viral pneumonia. She was admitted into our intensive care unit, and high dose of vitamin C, and tocilizumab (a humanized monoclonal antibody against the interleukin-6 receptor) were added to the treatment. The patient had increased respiratory difficulty (SpO2: %83) and was taken under the support of MV. Venovenous ECMO treatment was planned on the third day of intubation The results of a laboratory examination were leukocyte: 14.03 K/uL; neutrophiltolymphocyte ratio: 19.35; C-reactive protein: 244.8 mg/L; ferritin: 140.7 µg/L; procalcitonin: 14.7 ng/mL; D-dimer: 13.300 ng/mL and fibrinogen: 790 mg/Dl. The first polymerase chain reaction test was evaluated as SARSCoV-2 positive favipiravir 200 mg PO 2x3, piperacilin-tazobactam 3x4,5 gr IV and enoxaparin 6000 IU SC 2x1 were initiated. On the seventh day of ECMO, the patient developed sudden hypotension, metabolic acidosis, and P/F rate quickly dropped below 100. The patient died despite all the necessary interventions. Conclusion: ECMO indications are respiratory insufficiency, P/F ratio below 100, MV time of less than 7 days, age below 65 years. We could not achieve a successful result, we believe that new experiences. [ABSTRACT FROM AUTHOR]