Extracorporeal membrane oxygenation experiences during COVID-19 pandemic, third wave with younger patients: A retrospective observational study
Ahmet Oğuzhan Kucuk1, Mehtap Pehlivanlar Küçük1, Olcay Ayçiçek2, Gökalp Altun3, Ahmet Coşkun Özdemir3
1Department of Chest Diseases, Division of Intensive Care Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
2Department of Chest Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
3Department of Cardiovascular Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
Keywords: Coronavirus disease 2019, extracorporeal membrane oxygenation, mortality, pregnancy, SARS-CoV-2
OBJECTIVES: In this article, the results of severe coronavirus disease 2019 (COVID-19) cases followed with extracorporeal membrane oxygenation (ECMO) support in a 3-month period in the third wave when there were an increased number of cases of young patients in our intensive care unit (ICU) were presented.
METHODS: The study was carried out with all COVID-19 patients who were given ECMO support in our tertiary referral hospital ICU after obtaining the consent of the Ministry of Health Scientific Research Platform and after the approval of the local ethics committee. Patient data were obtained retrospectively from intensive care bedside follow-up charts and computer records. The demographic and clinical characteristics of the patients were presented in average, median, and percentages. The data of the patients were evaluated and compared with the current literature.
RESULTS: ECMO treatment was applied in seven patients who were followed up with severe COVID-19 pneumonia in the last 3 months. Venovenous extracorporeal membrane oxygenation (VV-ECMO) was applied to all patients. Five (71.5%) of seven patients were weaned from ECMO. Four (57.2%) of seven patients were discharged from the ICU and hospital in good health. While two of the patients had a cesarean section (C/S) before ECMO, one patient underwent C/S under ECMO. All three newborns were delivered via C/S and all were premature (C/S dates were 35 weeks, 32 weeks, and 27 weeks), and all were discharged from the hospital in good health.
CONCLUSION: Our experience shows that ECMO in COVID-19 patients is a lifesaving treatment option that can be successfully applied in severe acute respiratory distress syndrome cases who do not respond to conventional treatments.
The STROBE guideline was used as a guide for this manuscript. The study was prepared in accordance with the rules of the Helsinki Declaration. Our study was planned as a retrospective examination of the patient records of the Faculty of Medicine, Pulmonary Medicine Clinic, ICU. In addition to the informed consent of the patients, the study was approved by the Ministry of Health Scientific research platform with registration number of 2021 05 14 T20_34_19 regarding COVID 19 related studies and by the local ethics committee (Karadeniz Technical University, School of Medicine, No: 2021/368 dated November 15, 2021).
AOK: Conceptualization (equal), Formal analysis (lead), Writing – original draft (equal), Methodology (equal). MPK: Conceptualization (equal), Writing – original draft (equal), Methodology (equal). OA: Writing – review and editing (support), Supervision (support), Methodology (equal). GA: Writing – review and editing (support), Supervision (support), Methodology (equal). ACÖ: Writing – review and editing (support), Supervision (lead), Methodology (equal)
We would like to thank physicians Ayşegül Pehlivanlar, Taha Semerci, Ömer TOPALOĞLU, Kadir Çoban, Armağan Kaya, Özlem Güler, Semanur Balçık Savaşer, Büşra Özhan Akdemır, Esra Kongur, and Ufuk Doğan who never gave up their support for patients and perfusionist Cem Kara for his extraordinary effort.