Transesophageal Echocardiography-Guided Extracorporeal Membrane Oxygenation Cannulation in COVID-19 Patients
URL: https://www.jcvaonline.com/article/S1053-0770(22)00533-X/fulltext
Published online: Journal of Cardiothoracic and Vascular Anesthesia 30 July 2022
Doi: https://doi.org/10.1053/j.jvca.2022.07.020
Authors: Diana Morales Castro, Etienne Abdelnour-Berchtold, Martin Urner, Laura Dragoi, Marcelo Cypel, Eddy Fan, Ghislaine Doufle
Summary
- The article aim was to describe the use and safety of transesophageal echocardiography (TEE) for extracorporeal membrane oxygenation (ECMO) cannulation for confirmed COVID-19 patients;
- Single-center retrospective cohort study;
- The study included 107 patients with diagnosed SARS-CoV-2 infection who underwent bedside venovenous ECMO (VV ECMO) cannulation under TEE guidance between May 2020 and June 2021;
- Primary outcome: TEE-guided bedside cannulations was successful in 99% of the patients without major complications;
- Secondary outcome: no TEE related complications were diagnosed, 1 pneumothorax (1%) was diagnosed with TEE during cannulation;14 patients (13%) required cannula repositioning during ECMO support.
- Using bedside TEE for VV ECM cannulation was safe for all patients and for the treatment team.
Conclusion
- Bedside TEE guidance for VV ECMO cannulation is safe in patients with severe respiratory failure due to COVID-19;
- Further studies with a larger population are needed to determine risks for rare but severe complications related to VV ECMO cannulation under TEE guidance;
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