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Respiratory Care Profession

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Awake #ECMO in severe #COVID19 related #ARDS?? Feasible & avoiding need for invasive mechanical ventilation in selected patients! Here report of the case of a healthcare worker developing respiratory failure and emphysema on HFNC, supported with awake ECMO in spontaneous breathing to prevent worsening barotrauma/hemodynamic compromise potentially induced by positive pressure ventilation. Patient was alert, fully oriented, cooperating patient on HFNC (most of the time) & NIV (BiPAP). Patient, kept conscious without any sedation, received daily physiotherapy, including upper/lower limb muscle strengthening & power exercises + chest physiotherapy including tapping & incentive spirometry. After slow weaning from #ECLS, successful decannulation occurred under mild conscious sedation after 18 days of run; patient was discharged from ICU 5 days after decannulation, and discharged home after 54 days of hospital stay. Chest CT at 6 months showed dramatic improvement with minimal residual ground glass appearance in lower zones bilaterally. Open access #FOAMcc #FOAMecmo #COVIDFOAM https://bit.ly/3czXDjA
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Awake Extracorporeal Membrane Oxygenation in Coronavirus... : Critical Care Explorations

trial. Since then, extracorporeal membrane oxygenation has been incorporated as part of the standard treatment algorithm in many centers for patients with severe acute respiratory distress syndrome. Since the emergence of coronavirus disease 2019 in early 2020, extracorporeal membrane oxygenation has been used effectively as rescue therapy and as a bridge to recovery in some patients with refractory respiratory failure. DESIGN, SUBJECT, AND INTERVENTION: We present a 38-year-old male healthcare worker diagnosed with coronavirus disease 2019 and progressed to critical condition with severe surgical emphysema on a high-flow nasal cannula with Fio2 100%, a flow of 40 L/min, and a maximum oxygen saturation of 88%. He was successfully treated by applying awake extracorporeal membrane oxygenation, without a need for invasive mechanical ventilation, to avoid worsening barotrauma and hemodynamic compromise potentially induced by positive pressure ventilation. MAIN RESULTS AND CONCLUSIONS: To our knowledge,…

Hooman Poor - Basics of Mechanical Ventilation - Springer International Publishing (2018).
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Leo Heunks, Marcus J. Schultz - ERS Practical Handbook of Invasive Mechanical Ventilation - European Respiratory Society (2019).
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Susan R. Wilcox, Ani Aydin, Evie G. Marcolini - Mechanical Ventilation in Emergency Medicine - Springer International Publishing (2019).
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MCU 2021 Guyton & Hall Physiology Review (Guyton Physiology) 4th Edition CONVERTED PDF FROM EPUB
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