The ProtekDuo in ECMO configuration for ARDS secondary to COVID-19: A systematic review

Author:

Maybauer Marc O1234ORCID,Capoccia Massimo5,Maybauer Dirk M23,Lorusso Roberto6,Swol Justyna7,Brewer Joseph M1

Affiliation:

1. Nazih Zuhdi Transplant Institute, Advanced Cardiac and Specialty Critical Care, Oklahoma City, OK, USA

2. Department of Anaesthesiology and Intensive Care Medicine, Philipps University, Marburg, Germany

3. Critical Care Research Group, Prince Charles Hospital, University of Queensland, Brisbane, QLD, Australia

4. Department of Anesthesiology, Division of Critical Care Medicine, University of Florida College of Medicine, Gainesville, FL, USA

5. Department of Cardiac Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK

6. ECLS Centrum, Cardio -Thoracic Surgery Department, Heart & Vascular Center, Maastricht University Medical Center, Maastricht (MUMC), The Netherlands; and Cardiovascular Research Institute (CARIM), Maastricht, The Netherlands

7. Department of Pneumology, Allergology and Sleep Medicine, Paracelsus Medical University, Nuremberg, Germany

Abstract

Objective: Assessment of the results of the ProtekDuo cannula applied for dedicated right ventricular support with oxygenator in ARDS secondary to COVID-19. Methods: Systematic literature search in NHS library, Medline (Pubmed) and EMBASE using appropriate keywords as well as PICOS and PRISMA approach. Results: Out of 285 publications found, 5 publications met the search criteria and were included in this review. A total of 194 patients with ARDS secondary to COVID-19 underwent ProtekDuo placement to establish a combination of respiratory [veno-venous extracorporeal membrane oxygenation (V-V ECMO)] and right ventricular support. Patients treated using the ProtekDuo cannula had survival rates between 59% and 89% throughout the five studies, and a significant survival benefit when compared to an invasive ventilation group or compared to dual site V-V ECMO or other double lumen ECMO cannulas. One study focused on extubation and discontinuation of ventilator support, which could be achieved in 100% of ProtekDuo patients. An association for reduced incidence of acute kidney injury (AKI) and use of continuous renal replacement therapy (CRRT) could be shown when the ProtekDuo was used. Conclusion: Only limited literature is available for the ProtekDuo in V-P ECMO configuration in the setting of COVID-19 ARDS and should be interpreted with caution. Data on the ProtekDuo is suggestive for lower rates of mortality, AKI and CRRT as compared to other respiratory support modalities.

Publisher

SAGE Publications

Subject

Biomedical Engineering,Biomaterials,General Medicine,Medicine (miscellaneous),Bioengineering

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