Critical Care Commons^™

Covid-19 Induced Right Ventricular Failure And Right Ventricular Assist Device Support, Marvin Slepian M.D.

Journal of Shock and Hemodynamics

COVID-19, while primarily recognized for its pulmonary and systemic manifestations, afflicts the cardiovascular system through various abnormalities. Notably, right ventricular (RV) involvement leading to dysfunction and failure is a manifestation seen in up to 20% of severe COVID patients. RV severity correlates with overall COVID severity, serving as a prognostic marker. Data review reveals that RV failure was largely underdiagnosed, particularly early on in the pandemic. The therapy approach for RV failure in patients with COVID should focus on supporting overall RV perfusion pressure, maintaining sinus rhythm, optimizing RV loading conditions and contractility, and addressing anticoagulation and thrombus-related conditions. Beyond …

Extracorporeal Membrane Oxygenation Therapy In Covid-19 Patients With Acute Respiratory Distress Syndrome, Joseph B. Zwischenberger, Katherine Breetz

Journal of Shock and Hemodynamics

Patients with coronavirus disease of 2019 (COVID-19) may present with a wide range of symptoms ranging from asymptomatic to critically ill. Approximately 10-14% of patients require hospitalization. Those individuals requiring hospitalization can deteriorate rapidly with worsening hypoxemia or new-onset pneumonia, resulting in 20-30% of patients developing acute respiratory distress syndrome (ARDS).

When refractory to medical management, severe ARDS secondary to other illnesses has been successfully treated with extracorporeal membrane oxygenation (ECMO). We completed a comprehensive literature review of ECMO utilization for patients with severe COVID-19 who were unresponsive to critical care management. Of the 1419 patients with a reported diagnosis …