ECMO in COVID-19: What we have learned thus far? Lot of interesting topics & points of view discussed during this ELSO webinar, on April 22! Speakers & topics:
Christian Bermudez & Holt Murray: regional coordination and collaboration on patients selection, cannulation, transfer, management strategies…
Erik Osborn: successful ECMO support experiences, general management & procedures on extracorporeal support
Troy Seelhammer & Tim Maul: hypercoagulable state of patients with Coronavirus infection & approaches to anticoagulation; circuits/devices shortage & potential alternatives.
Here the slides!
Christian Bermudez, Professor of Surgery and Director of Thoracic Transplantation – Department of Surgery – University of Pennsylvania: ECMO Center Organization and Regional Coordination
Holt Murray, Department of Critical Care Medicine, Chief of Service UPMC Mercy and Assistant Professor, Critical Care Medicine, University of Pittsburgh School of Medicine
Regional ECMO Coordination – 10 years in 10 minutes
Erik Osborn, Medical Director of Adult ECMO – Inova Health System,
COVID-19 & ECMO: Experiences and Management
Timothy M. Maul Perfusionist and Sr. Researcher – Nemours Children’s Hospital and Adjunct Asst. Professor, Biomedical Engineering, University of Pittsburgh
Inflammation & Coagulation for SARS-COV-2: Perfusionist’s Perspective
Troy Seelhammer, Assistant Professor of Anesthesiology & Critical Care Medicine & Adult ECMO Medical Director – Mayo Clinic, Rochester, MN
ECMO in COVID-19: Is There a Role for Bivalirudin?
Full video available on our youtube channel
The ECMOCARD Study first steps, trying to understand provide best care to COVID-19 patients who need critical care in ICU, from local outbreaks of Novel Coronavirus, to global pandemics of SARS-CoV-2. December, 26 2019: 4 unusual cases of pneumonia reported at HICWH Hospital in Wuhan, China; on January, 21 2020, first draft: ExtraCorporeal Membrane Oxygenation for 2019 WUhan CORonavirus Infection The ECMOWUCOR Observational trial, with study protocol in Chinese, Korean and Japanese one week later. At the end of January, ECMOWUCOR has been linked with SPRINT-SARI, Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection, & ISARIC, International Severe Acute Respiratory and Emerging Infection Consortium. On February, 4 2020, study title & acronym changed to ECMOCARD, ExtraCOrporeal Membrane, Oxygenation for novel Coronavlrus Acute Respiratory Disease… Work is in progress!
Collaboration mandatory: join & support ECMOCARD Study involving (to date):
286 Collaborative Centers
15 Recruiting Centers
with 265 enrolled Patients
All Trial Documents available here.
Additional info & graphics available.
Any question?? send email to ECMOCARD@ELSO.org
The Extracorporeal Life Support Organization – ELSO COVID-19 Dashboard is now live! We are asking centers Worldwide to support us capture vital informations to assist in the fight against SARS-CoV-2 Coronavirus: here a video with easy step-by-step instructions on how to quickly add data into the Registry!
Non-ELSO Centers contact firstname.lastname@example.org for CenterID and login
Remember all red highlighted fields must be completed for your submission to be saved.
Direct link to Dashboard
The power of connection: at a time when social distancing is a universal necessity, connecting as a healthcare community has never been so vitally important to keeping our patients & colleagues safe. This ELSO webinar focused on sharing experiences from around the globe that are currently in the surge phase. Highlights:
Pearls from a COVID-19 dedicated WhatsApp chat: popular discussion topics, best practices & advices shared by ECLS experts.
Stories from the front lines: preparing for the surge, indication, selection criteria & configuration for ECMO support in SARS-CoV-2 related severe respiratory failure & hemodynamic impairment, with some numbers about extracorporeal support implementation so far:
Seattle Experience by Jenelle Badulak
New York City Experience by Cara Agerstrand
Paris Experience by Matthieu Schmidt.
Here full video
And here the slides!
Tammy Friedrich, MSN, RN, BSN, ECMO Specialist at Mayo Clinic in Rochester, MN
Amy Hackmann, MD, FACS, Associate Professor in the Department of Cardiovascular and Thoracic Surgery at UT Southwestern Medical Center
Holli Williams, RN, BSN, CCRN, ECMO and VAD Specialist and Preceptor – Innovative ECMO Concepts Inc
What Have We Learned from Each Other
Jenelle Badulak, MD, Emergency Medicine & Critical Care Medicine University of Washington, Seattle, WA
COVID ECMO Preparation & Experiences In Washington
Matthieu Schmidt, MD, PhD – Service de Réanimation iCAN, Institute of Cardiometabolism and Nutrition Hôpital Pitié-Salpêtrière, AP-HP, Paris
Université Pierre et Marie Curie, Paris 6
ECMO and COVID-19: Experience from Paris
In a time of global crisis, global collaboration is essential: join & support ECMOCARD Study: how to provide best care to COVID-19 patients who need critical care in ICU? In the pictures, some of the international collaborators of ECMOCARD & updated active sites map!
All ECMOCARD Trial Documents available on the ELSO website
Any question?? send email to ECMOCARD@ELSO.org
Current situation of ECMO use in Japan for COVID-19 associated ARDS: second ELSO webinar focused on the use of ECLS during the SARS-CoV-2 pandemics, run on March 30th. Highlights:
case presentation of patient from Diamond Princess cruise ship requiring ECLS
transport of patients on extracorporeal support
coagulopathy on ECMO
& more… Here full video, and the slides, available for download.
Shingo Ichiba, Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Tokyo, Japan.
ECMO for COVID-19-Experience in Japan
Keibun Liu, Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan:
An assessment of aerosolization via membranous oxygenator and coagulopathy in COVID-19
Ryuzo Abe, Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan:
Multiple Organ Dysfunction in COVID-19 Cases
Ichiro Takeuchi, Advanced Critical Care Medicine, Yokohama City University Hospital, Yokohama, Japan:
How we treat Cruise Ship Diamond Princess with 3700 passengers
Takayuki Ogura, Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan:
ECMO case in Utsunomiya Hospital
Here some suggested readings related to the webinar topic, all full texts are open access:
First article report a case of successful implementation of veno-venous ECMO on a cruise passenger tested positive for SARS-CoV-2 Coronavirus https://bit.ly/2UOHFIR
A report describing findings from the initial phase of a cruise ship investigation into COVID-19 cases among crew members during quarantine. Full text
Data about chronology of COVID-19 cases on the cruise ship, with ethical considerations related to infection control, including the reasonable justification for isolation, the psychological fragility and quality of life of the isolated passengers and crew members, the procedural justice inherent in a forced quarantine, and the optimization of control measures. Full text.
First Extracorporeal Life Support Organization webinar dedicated to the role of extracorporeal support in patients with SARS-CoV-2 infection, speakers:
Michael A. Matthay, MD Departments of Medicine & Anesthesia Cardiovascular Research Institute University of California, San Francisco
Acute Respiratory Distress Syndrome – with Special Reference to COVID-19
A/Prof Kiran Shekar, Adult Intensive Care Services and Critical Care Research Group – The Prince Charles Hospital, Brisbane, Australia
Provision of ECMO During COVID-19 and Other Pandemics
K.R. Ramanathan, Department of Cardiothoracic Intensive Care Unit, Dept of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, National University Hospital, Singapore.
Infection Control Measures during ECMO for CoVID-19
Here full video, and all the slides, available for download.
Open access book: COVID-19 prevention & treatment by First Affiliated Hospital, Zhejiang University School of Medicine: three sections,
infection prevention and control management
diagnosis & management
including an ECMO support for SARS-CoV-2 section: timing for implementing ECLS, configuration & settings, management, monitoring & complications: waiting for more data from ECMOCARD study!
Thanks to the authors & editors for writing and sharing as open access this important resource!
A global crisis needs a global response and global collaboration. In an unknown disease, ECMOCARD Study Group is coordinating with 26 countries across 4 continents to share data real-time.
With these data, we will use Artificial Intelligence to produce machine learning and feed back decision support to clincians who are currently “driving blindfold” in this entirely new and poorly understood condition.
Our best current asset is shared experience and global data to guide treatment today and tomorrow. But research needs to be supported!
Here a letter to the Political Leaders of Australia, signed by Professor John Fraser, Professor Robert Bartlett and by by all the regional Leads of the study (full list in the dedicated picture).
“The Covid-19 pandemic is an unprecedented global situation. The WHO calculates that between 60 and 80 per cent of the world population will be infected. This will place an overwhelming burden on hospitals in general, but specifically on intensive care resources. Never before have we seen this disease, nor its magnitude. We have no data on how best to care for our patients – specifically your parents. Without data, we are driving blindfold at 100 Km/h – with your relatives ir the vehicle.
Australian medical leaders realised the urgent necessity to gather key treatment information They stood up to this challenge – and created “ECMOCARD ” – the only global study to gather data or the ICU management of the sickest and most vulnerable patients. It is a great example of the globa medical community working as one- for the good of the global patients.
In representing the global ICU community, we respectfully and humbly ask the Australiar Government to align themselves with their medical leaders and take the leap. Support of the ECMOCARD global collaboration can assist the global community.
Australian Political Leaders should stand shoulder to shoulder with their Medical Leaders – for the sake of us all.
In these pictures, a list of the International ECMOCARD Study regional Leads (all of the have co-signed the letter), and a map with the active sites: the list is continuously updated, as more and more centers, in more Countries, are being involved, and join the study group.
We currently have 104 collaborating centres, and a further 7 sites anticipated to come on board in the near future. This is a fantastic effort on behalf of all collaborating sites and speaks volumes of the importance and clinical relevance of the data we are collecting (Sites map is superimposed to the online dashboard for tracking worldwide spread of the Coronavirus has been built & is regularly updated by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University; the map is freely available and constantly updated link).
Recently Professor John Fraser released an interview to Norman Swan for ABC’s Health Report and, discussing how intensive care specialists will deal with the influx of patients with SARS-CoV-2 infection. “We’ve got a global responsibility for our global community,” Professor Fraser said. Details about interview & full video here.