Evidence map›Paper›PMID 33918355›Full record

ArticleMembranes2021

A Dedicated Veno-Venous Extracorporeal Membrane Oxygenation Unit during a Respiratory Pandemic: Lessons Learned from COVID-19 Part I: System Planning and Care Teams.

Sagar Dave, Aakash Shah, Samuel Galvagno, Kristen George, Ashley R Menne, Daniel J Haase, Brian McCormick, Raymond Rector, Siamak Dahi, Ronson J Madathil and 9 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Membranes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 3 institutions in 1 country.

Sagar DaveDepartment of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Aakash ShahDepartment of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.ORCID 0000-0003-2302-733X
Samuel GalvagnoDepartment of Anesthesiology, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Kristen GeorgeDepartment of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Ashley R MenneDepartment of Emergency Medicine, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.ORCID 0000-0003-2348-5541
Daniel J HaaseDepartment of Emergency Medicine, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Brian McCormickPerfusion Services, University of Maryland Medical Center, Baltimore, MD 21201, USA.
Raymond RectorPerfusion Services, University of Maryland Medical Center, Baltimore, MD 21201, USA.
Siamak DahiDepartment of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Ronson J MadathilDepartment of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Kristopher B DeatrickDepartment of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Mehrdad GhoreishiDepartment of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
James S GammieDepartment of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
David J KaczorowskiDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Thomas M ScaleaDepartment of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Jay MenakerDepartment of Surgery, University of California San Francisco Medical Center, San Francisco, CA 94143, USA.
Daniel HerrDepartment of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Eric KrauseDepartment of Surgery, Division of Thoracic Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Ali TabatabaiDepartment of Medicine, Division of Pulmonary and Critical Care, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.ORCID 0000-0002-5325-4907
University of Maryland, Baltimore · USUniversity of California San Francisco Medical Center · USUniversity of Pittsburgh Medical Center · US

Funding

NRSA Training CoreTL1TR003100 · NCATS · JOHNS HOPKINS UNIVERSITY · PI SAHA, SOMNATH · 2019 to 2023
$4.5M
NCATS NIH HHS TL1 TR003100
6 · The paper itself

Abstract

backgroundThe most critically ill patients with coronavirus disease 2019 (COVID-19) may require advanced support modalities, such as veno-venous extracorporeal membrane oxygenation (VV-ECMO). A systematic, methodical approach to a respiratory pandemic on a state and institutional level is critical.

methodsWe conducted retrospective review of our institutional response to the COVID-19 pandemic, focusing on the creation of a dedicated airlock biocontainment unit (BCU) to treat patients with refractory COVID-19 acute respiratory distress syndrome (CARDS). Data were collected through conversations with staff on varying levels in the BCU, those leading the effort to make the BCU and hospital incident command system, email communications regarding logistic changes being implemented, and a review of COVID-19 patient census at our institution from March through June 2020.

resultsOver 2100 patients were successfully admitted to system hospitals; 29% of these patients required critical care. The response to this respiratory pandemic augmented intensive care physician staffing, created a 70-member nursing team, and increased the extracorporeal membrane oxygenation (ECMO) capability by nearly 200%. During this time period, 40 COVID-19 patients on VV-ECMO were managed in the BCU. Challenges in an airlock unit included communication, scarcity of resources, double-bunking, and maintaining routine care.

conclusionsPreparing for a surge of critically ill patients during a pandemic can be a daunting task. The implementation of a coordinated, system-level approach can help with the allocation of resources as needed. Focusing on established strengths of hospitals within the system can guide triage based on individual patient needs. The management of ECMO patients is still a specialty care, and a systematic and hospital based approach requiring an ECMO team composed of multiple experienced individuals is paramount during a respiratory viral pandemic.

Indexed as

acute respiratory distress syndromebiocontainment unitCOVID-19extracorporeal membrane oxygenation

Identifiers

PMID33918355
PMCPMC8065909
OpenAlexW3149849073

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.