Nationwide system to centralize decisions around ECMO use for severe COVID-19 pneumonia in Japan (Special

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Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
03:40

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

663

    Journal of Intensive Care
    |April 29, 2020
    PubMed

    Insights

    Extracorporeal membranous oxygenation (ECMO) was used for 26 COVID-19 patients in Japan. Two COVID-19 phenotypes were observed, with preserved lung compliance potentially benefiting from ECMO support.

    Area of Science:

    • Critical Care Medicine
    • Pulmonology
    • Infectious Diseases

    Background:

    • The novel coronavirus disease 2019 (COVID-19) pandemic has led to a significant increase in patients requiring critical care.
    • Extracorporeal membranous oxygenation (ECMO) is a life support measure for severe respiratory failure, but its optimal use in COVID-19 patients remains under investigation.

    Purpose of the Study:

    • To analyze the characteristics and outcomes of COVID-19 patients requiring ECMO in Japan.
    • To identify potential phenotypes of COVID-19 that may benefit from ECMO.

    Main Methods:

    • Retrospective analysis of 26 COVID-19 patients treated with ECMO.
    • Collection of demographic data, respiratory parameters (PaO2/FiO2 ratio, PEEP, MAP, lung compliance), and serum KL-6 levels.
    • Assessment of ECMO weaning, extubation, and rehabilitation rates.

    Main Results:

    • The median age of the 26 ECMO patients was 71 years.
    • Key respiratory parameters included a median PaO2/FiO2 ratio of 70, PEEP of 15 cmH2O, MAP of 21 cmH2O, and lung compliance of 28 mL/cmH2O.
    • Outcomes showed 62% (16/26) were weaned off ECMO, 26% (6/26) were extubated and undergoing rehabilitation, and 38% (10/26) remained on ECMO.

    Conclusions:

    • Two distinct COVID-19 phenotypes were suggested: one with impaired lung compliance and another with preserved lung compliance.
    • Patients with preserved lung compliance appeared to have a better response to ECMO.
    • Further research is needed to define the optimal indications for ECMO in COVID-19 patients.

    Keywords:
    Acute respiratory failureComplianceKL-6Mechanical ventilationPrognosis

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