COV6: Chest Tubes in COVID-19 Patients on Extracorporeal Membrane Oxygenation: Time To Revisit Our Approach?

作者：Melina Shoni, Jason J. Han, Salim E. Olia, Anahita Parsee, Audrey E. Spelde, Asad Usman, William J. Vernick, Jacob T. Gutsche · 发表于：ASAIO Journal · 年份：2022 · DOI：10.1097/01.mat.0000841076.40682.0b · 研究领域：Mechanical Circulatory Support Devices、COVID-19 Clinical Research Studies、Transplantation: Methods and Outcomes

Objectives: The purpose of this study was to compare the outcomes of chest tubes (CT) inserted via three approaches in COVID-19 patients undergoing extracorporeal membrane oxygenation (ECMO): open thoracostomies (OT), percutaneously at bedside (PERC), and percutaneously by interventional radiology (PERC IR). Methods: We conducted an institutional review board - approved retrospective study of all COVID-19 patients who required CT placement while undergoing ECMO in our institution from February 2020 till February 2022. Insertions prior to ECMO cannulation or after decannulation, and those related to post-operative lung transplantation during ECMO were excluded from our analysis. Depending on the insertion approach, eligible CT insertion events were divided in three groups: OT, PERC and PERC IR. Data regarding patients’ demographics and CT characteristics, clinical indications and associated complications for each group were collected and analyzed. Bleeding related to CT insertion was diagnosed based on requirement of blood transfusion, cessation of anticoagulation and/or ongoing bloody CT output. Results: Study criteria were met by 43 patients, with 35 (83.7%) of male sex. Mean age was 45 years. Mean BMI was 31.6 kg/m2. Forty patients (93.0%) had COVID-related acute respiratory distress syndrome as primary diagnosis. All patients but one had been receiving therapeutic anticoagulation which was held prior to CT insertion. Eighty-seven CT insertion events were recorded, of which...