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Efficacy of multidisciplinary team approach with extracorporeal membrane oxygenation for COVID-19 in a low volume ECMO center.
- Source :
-
Artificial organs [Artif Organs] 2021 Sep; Vol. 45 (9), pp. 1061-1067. Date of Electronic Publication: 2021 Apr 16. - Publication Year :
- 2021
-
Abstract
- Veno-venous extracorporeal membrane oxygenation (VV ECMO) is an effective and proven adjunct support for various severe respiratory failures requiring invasive mechanical ventilation and cardiovascular support. In response to the rapidly increasing number of COVID-19 patients in Japan, we launched an ECMO support team comprised of multidisciplinary experts including physicians, nurses, perfusionists, and bioethicists in preparation for the threat of a pandemic. From April 2 to July 15, 2020, Tokyo Medical and Dental University hospital treated 104 PCR confirmed COVID-19 patients. Among those, 34 patients were admitted to intensive care unit (ICU) and 5 patients required VV ECMO. All management related to ECMO was decided by the ECMO support team in addition to participation of the ECMO support team in daily multidisciplinary rounds in the ICU. Median age was 54 years old. Duration from onset to mechanical ventilation (MV) and MV to ECMO were 8 and 7 days, respectively. Four patients (80%) were successfully weaned off from ECMO. One patient died after 81 days of ECMO run. Four patients were discharged and recovered to their prehospital quality of life without major disability. We achieved a high survival rate using ECMO in our low volume ECMO institution during the COVID-19 pandemic. Multidisciplinary decision-making and a team approach for the unclear pathology with an emerging infectious disease was effective and contributed to the survival rate.<br /> (© 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.)
- Subjects :
- Adult
Aged
COVID-19 diagnosis
COVID-19 mortality
COVID-19 physiopathology
Cooperative Behavior
Female
Hospital Mortality
Humans
Interdisciplinary Communication
Male
Middle Aged
Recovery of Function
Respiration, Artificial
Retrospective Studies
Time Factors
Time-to-Treatment
Tokyo
Treatment Outcome
COVID-19 therapy
Extracorporeal Membrane Oxygenation adverse effects
Extracorporeal Membrane Oxygenation mortality
Hospitals, Low-Volume
Patient Care Team
Subjects
Details
- Language :
- English
- ISSN :
- 1525-1594
- Volume :
- 45
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Artificial organs
- Publication Type :
- Academic Journal
- Accession number :
- 33656783
- Full Text :
- https://doi.org/10.1111/aor.13947