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. 2020 Apr 30;10.1097/MAT.0000000000001180.
doi: 10.1097/MAT.0000000000001180. Online ahead of print.

Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO-A "Living Working Document"

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Free PMC article

Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO-A "Living Working Document"

Keshava Rajagopal et al. ASAIO J. .
Free PMC article

Abstract

The severe acute respiratory syndrome (SARS)-CoV-2 is an emerging viral pathogen responsible for the global coronavirus disease 2019 (COVID)-19 pandemic resulting in significant human morbidity and mortality. Based on preliminary clinical reports, hypoxic respiratory failure complicated by acute respiratory distress syndrome is the leading cause of death. Further, septic shock, late-onset cardiac dysfunction, and multiorgan system failure are also described as contributors to overall mortality. Although extracorporeal membrane oxygenation and other modalities of mechanical cardiopulmonary support are increasingly being utilized in the treatment of respiratory and circulatory failure refractory to conventional management, their role and efficacy as support modalities in the present pandemic are unclear. We review the rapidly changing epidemiology, pathophysiology, emerging therapy, and clinical outcomes of COVID-19; and based on these data and previous experience with artificial cardiopulmonary support strategies, particularly in the setting of infectious diseases, provide consensus recommendations from ASAIO. Of note, this is a "living document," which will be updated periodically, as additional information and understanding emerges.

Conflict of interest statement

Disclosure: Dr Slepian has research grants from Abiomed and NIH/NIBIB. Dr Keller has research grant from Abiomed and NIH. Dr Bime has a research grant from NIH/NHLBI. Dr Zwischenberger has research grants from Avalon-Maquet and NIH and is an unpaid consultant for Cytosorbents; Dr El-Banayosy has a research grant from Abbott. The other authors have no conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Algorithm for supportive care for ARDS secondary to COVID-19 infection. ARDS, acute respiratory distress syndrome; ECMO, extracorporeal membrane oxygenation.

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