No additional COVID-19 risk for ECMO transport tea

November 22, 2021 – Critically ill patients with COVID-19 can be safely transported for vital extracorporeal membrane oxygenation (ECMO) therapy – without increased risk of transmitting the transmission of COVID-19 to members of the ECMO transport team by following standard precautions, reports a study in the ASAIO Journal, official journal of the American Society for Artificial Internal Organs. The journal is published in the Lippincott portfolio by Wolters Kluwer.

In a large series of COVID-19 patients transported for ECMO, there have been no cases of transmission of SARS-CoV-2 to members of the transport team, according to the report by Jeffrey Javidfar, MD, of Emory University, Atlanta, and colleagues. “This pandemic and COVID-19 present a particular challenge for ECMO reference centers”, comments Dr Javidfar. “But with thoughtful planning and meticulous execution, patients with acute respiratory distress syndrome secondary to COVID-19 can be remotely cannulated and then returned to an ECMO center without posing an increased risk to the patient or the team. transport.”

Experiment Supports ECMO Transport Safety for COVID-19 Patients

Extracorporeal membrane oxygenation is a life-sustaining therapy for some critically ill patients. Like cardiopulmonary bypass during surgery, ECMO takes over the work of the heart and lungs, but for a period of a few days or weeks, rather than a few hours. Well established for use in patients with other causes of acute respiratory distress, ECMO offers a chance of survival for a subset of patients with severe COVID-19.

Requiring specialized equipment and highly skilled professionals, ECMO is mainly provided in large medical centers. Typically, ECMO teams travel to where the patient is hospitalized, initiate resuscitation, and return the patient to the originating hospital for ECMO care. But transporting COVID-19 patients could pose a risk of transmitting SARS-CoV2 to members of the ECMO transport team, as well as a risk of complications and adverse effects for patients.

To assess the safety of ECMO transport, Dr Javidfar and colleagues looked at data from 101 COVID-19 adult patients (average age 46) transported to five different ECMO hospitals around the world. Most of the patients were transported by land (ambulance), but 10 were transported by air. The average trip distance was 40 miles (36 miles by land and 66 by plane) and the average travel time was 134 minutes.

Each multidisciplinary ECMO team consisted of doctors, intensive care nurses, an ECMO specialist or perfusionist, and a driver or pilot. Team members followed strict Air Contact Precautions (ACE) and Personal Protective Equipment (PPE) protocols, including face shield or goggles, respirator or face shield. N95 or higher, gloves and an isolation gown. “Special care was taken not to violate the ACE and PPE protocol from the time the team came into contact with the patient until they returned to their respective ECMO center,” the researchers write.

Evidence supported the safety of ECMO transport for COVID-19, both for patients and for members of the ECMO mobile team. None of the patients presented with transport-related complications such as pump failure or problems with catheters placed for ECMO access.

Besides, “[T]there have been no cases of transport team members contracting COVID-19 [within] 21 days after transport ”, write Dr Javidfar and colleagues. This is consistent with previous studies showing that providers in intensive care units are not at increased risk of transmitting SARS-CoV2, compared to the general population.

Patients remained on ECMO for an average of 22 days. Forty-four percent of patients survived hospital discharge – a rate consistent with the growing experience with ECMO support for severe COVID-19.

The five hospitals that contributed to the study were part of the COVID-19 Intensive Care Consortium – a global alliance of healthcare professionals and researchers committed to using breakthrough technology to identify the most effective treatments for the most seriously ill COVID-19 patients.

“The COVID-19 Critical Care Consortium is a truly global collaboration that has made this research possible,” comments lead author Giles Peek, MD, of the University of Florida, Gainesville. “By informing the clinical practice of clinicians caring for patients during the COVID-19 pandemic, the Consortium transcends institutional and national boundaries, as this article illustrates. “

Click here to read “Mobile extracorporeal membrane oxygenation for Covid-19 poses no additional risk to the transport team”

DOI: 10.1097 / MAT.0000000000001602

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On ASAIO Journal

ASAIO Journal, the official publication of American Society for Artificial Internal Organs, is at the forefront of research and development of artificial organs. At the forefront of innovative technology, it features the highest quality peer-reviewed articles that describe research, development, the most recent advancements in the design of artificial organ devices, and initial test results. Published in eight issues per year, the ASAIO Journal features cutting-edge investigations, laboratory and clinical trials, as well as discussions and expert opinion from around the world.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions and services for clinicians, nurses, accountants, lawyers and the tax, finance, audit, risk, compliance and regulation. We help our clients make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer achieved 2020 annual sales of 4.6 billion euros. The group serves customers in more than 180 countries, maintains operations in more than 40 countries and employs approximately 19,200 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides reliable clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision making and outcomes across healthcare. We support clinical efficacy, learning and research, clinical monitoring and compliance, and data solutions. For more information on our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

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