- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Role of ECMO in most critically ill COVID-19 patients
Extracorporeal membrane oxygenation (ECMO) is an advanced, resource-intensive form of life support for patients with severe respiratory or cardiac failure, and is typically provided within specialized centres. In a recent review article, researchers have given guidance for clinicians on the role of ECMO in managing critically ill COVID19 patients.
The paper was published online in JAMA on December 17, 2021.
Nearly 2 years into the pandemic, the role of ECMO for COVID-19 is slowly coming into focus. As of November 2021, more than 10 500 patients with COVID-19 have been treated with ECMO and reported to the Extracorporeal Life Support Organization. The optimal distribution of resources between critically ill patients with COVID-19 treated or not treated with ECMO, however, cannot be precisely adjudicated because of the current, uncontrolled evidence base. Therefore, Dr Daniel Brodie and his team provided 3 approaches to manage ECMO use in critically ill covid patients.
♦ Firstly, they noted that clinicians should regularly review the criteria used to determine ECMO candidacy to minimize ECMO use in patients unlikely to survive, including those with advanced age or severe multiorgan failure.
♦ Secondly, they noted that based on the existing supply, regional ECMO capabilities should be optimized by sharing resources and coordinating referrals.
- They insist on the fair and rational use of ECMO, expediting the transfer of patients to ECMO centres with appropriate capacity, and keeping ECMO teams informed as to utilization rates across each region in real-time.
- They further advised increasing the ECMO capability by establishing new ECMO centres.
♦Thirdly, they suggested more robust study designs to evaluate the potential benefits of ECMO for COVID-19. They recommended adaptive trail design with outcomes of interest beyond short- and longer-term mortality including resource consumption, cost, functional outcome and quality of life.
The authors wrote, "There are rapidly increasing treatment options beyond supportive care, including antiviral therapies, monoclonal antibodies, and immunosuppressants. Both current and future treatments are expected to be more successful than in the prevaccination phase of the pandemic and may obviate the need for ECMO in many patients."
They concluded, "ECMO remains a therapy of last resort for COVID-19, used for highly selected patients with refractory ARDS who have failed trials of lung-protective ventilation strategies and prone positioning. Regional health care networks and governments should continue to monitor outcomes for patients with COVID-19 treated with ECMO and work toward judiciously managing ECMO resources for all critically ill patients."
They further added, "The use of ECMO has become increasingly established for patients with COVID-19–related ARDS. Nonetheless, it is likely that the optimal place for ECMO in the algorithm for COVID-19 will continue to evolve, as it joins a widening spectrum of increasingly available treatments in a changing patient population."
For further information:
Medical Dialogues Bureau consists of a team of passionate medical/scientific writers, led by doctors and healthcare researchers. Our team efforts to bring you updated and timely news about the important happenings of the medical and healthcare sector. Our editorial team can be reached at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751