Author: M Velia Antonini

Critical care & ECMO in the era of COVID-19: why data matters

Critical care & ECMO in the era of COVID-19: why data matters! ELSO webinar, moderated by Dr. Robert Bartlett & Matt Paden, highlighting the current research underway focused on better understanding the impact of COVID-19, and the role of extracorporeal support and ICU care in patients with SARS-CoV-2 Coronavirus infection. Topics & speakers:
ELSO Registry and the live dashboard for COVID-19 Cases: Matt Paden & Ryan Barbaro
EuroELSO Survey on ECLS in COVID-19, Roberto Lorusso & Jan Bělohlávek
COVID-Critical Care Consortium, John Fraser & Heidi Dalton

Here full replay!

… and some slides:

Barbaro R.: We always know data matters! since H1N1 pandemic: now, more than 10 years later, COVID- 19 presented uncertainty & dynamic understanding, but thanks to community data soon start arriving, through:
ELSO Registry COVID-19 addendum and live dashboard
COVID critical care consortium
EuroELSO survey on ECMO in COVID-19

Lorusso R.: with @jan_belohlavek sharing (preliminary) data but really interesting insights from EuroECMO COVID, the scientific “adventure” of EuroELSO survey, amazing collection of data in really short ime, thanks to EuroELSO & collaborative centers.

Fraser J.: presenting COVID critical care consortium, global collaboration of more than 330 hospital across 50 countries, 1021 patients enrolled to date, aimed to characterize COVID-19 ICU pts, & its subgroups: we need data to get whole picture!

And please take the ongoing related surveys, ie neonatal and pediatric ICU & ECMO survey http://bit.ly/3d7MSmR aimed to acquire basic informations on neonates & pediatric SARS-CoV-2 Coronavirus patients requiring ICU admission/ECMO, or the ethics ECMO & pandemis survey.

ECMO in COVID-19: What have we learned so far?

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,
Northern Virginia
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

ECMOCARD study, the story

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):
43 Countries
6 Continents
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

ELSO COVID-19 Dashboard

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!
Key takeaways:
Non-ELSO Centers contact membership@elso.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

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

ECMOCARD study update

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

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.


Speakers:

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.

Preparing to support COVID-19 patients on ECMO

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

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
nursing…
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!