Extracorporeal Membrane Oxygenation in COVID-19 Patients with Acute Respiratory Disorder Syndrome: Literature Review

Puji Nurani, F. Rosyid
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Abstract

Email: fnr200@ums.ac.id ABSTRACT Background: COVID-19 is an infectious disease caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It develops into acute respiratory distress and the majority of affected patients are placed under respiratory assistance in the intensive care unit. Furthermore, several efforts have been made to treat this condition, and these include refractory to mechanical ventilation, and Extracorporeal Membrane Oxygenation (ECMO) therapy following the guidelines recently published by the Extracorporeal Life Support Organization (ELSO). Objectives: This study aims to identify the effectiveness of using ECMO therapy in prolonging the life expectancy of COVID-19 patients with Acute Respiratory Distress Syndrome (ARDS) in the intensive care unit (ICU). Methods: This literature review identified 6 relevant studies following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). Results: A total of 32 from 157 full-text articles were analyzed based on the eligibility criteria. Meanwhile, up to 6 selected articles were obtained, including 263 for COVID-19 patients that required ECMO therapy in the ICU. A total of 119 were decannulated and discharged from the ICU/hospital, 25 were still being treated with ECMO and 119 died. The factors that influence the success rate of using ECMO in patients are age, gender, comorbidities, and complications during the initiation process. Conclusion: Different reports showed that COVID-19 patients with ARDS have a high mortality rate. Therefore, alternative therapy such as ECMO should be provided to prolong life expectancy by considering the patient's indications and contraindications before the initiation of
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体外膜氧合治疗COVID-19急性呼吸障碍综合征:文献综述
摘要背景:COVID-19是一种由急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的传染病。它发展为急性呼吸窘迫,大多数受影响的患者在重症监护病房接受呼吸辅助。此外,已经做出了一些努力来治疗这种情况,其中包括机械通气的难治性,以及根据体外生命支持组织(ELSO)最近发布的指南进行体外膜氧合(ECMO)治疗。目的:本研究旨在确定ECMO治疗对延长重症监护病房(ICU)新冠肺炎合并急性呼吸窘迫综合征(ARDS)患者预期寿命的有效性。方法:本文献综述根据系统评价和元分析首选报告项目(PRISMA)的指南确定了6项相关研究。结果:根据入选标准对157篇全文文章中的32篇进行了分析。同时,共获得6篇入选文章,其中263篇为需要在ICU进行ECMO治疗的COVID-19患者。119例患者停用体外循环并出院,25例仍在ECMO治疗,119例死亡。影响患者使用ECMO成功率的因素有年龄、性别、合并症和启动过程中的并发症。结论:不同报道均显示COVID-19合并ARDS患者死亡率高。因此,在开始治疗前应考虑患者的适应症和禁忌症,提供ECMO等替代治疗以延长预期寿命
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