De-identified information from patients who fought COVID-19 in the Nebraska Medical Center's intensive care units (ICUs) could soon help influence the critical care pandemic response around the globe.
About the study
The research study is commonly referred to as ECMOCARD, short for Extracorporeal Membrane Oxygenation for 2019 novel Coronavirus Acute Respiratory Disease. Extracorporeal Membrane Oxygenation (ECMO) is a form of life support that partially replaces heart and lung function.
The prospective/retrospective study analyzes 28 days-worth of de-identified information about COVID-19 positive patients who were newly admitted to an ICU at a participating site. Data is compiled from all critically ill COVID-19 patients, whether they were placed on a ventilator, ECMO, or neither.
The study's objectives are to describe clinical features, the severity of breathing difficulties, technical characteristics of needing ECMO, and the duration, complications, and survival of patients with COVID-19. Data collected will also be used in a subset of studies focusing on a wide range of areas including neurological effects, cardiac effects, bleeding and clotting disorder, ethics and acute kidney injury.
UNMC/Nebraska Medicine is now one of more than 350 medical centers in 48 countries participating in a study on critically ill COVID-19 patients. The study is hosted by the COVID-19 Critical Care Consortium (CCC), a global group of clinicians and scientists who united in response to the pandemic. The aim of the CCC is to help intensive care clinicians provide the best and most up-to-date information to save lives and improve patient outcomes.
The principal investigator leading UNMC's participation is Shaun Thompson, M.D., assistant professor in the UNMC Department of Anesthesiology and medical director of Extracorporeal Membrane Oxygenation (ECMO) -- a form of life support that partially replaces heart and lung function. Currently, UNMC is the only medical center in Nebraska participating in the study.
"Clinicians do the best they can for every patient they have, but information and resources are currently limited during this global crisis," Dr. Thompson said. "We have to be cautious and realistic in selecting which patients will benefit from interventions like ECMO. This study can help us make those decisions through global research and collaboration."
By studying the clinical course of COVID-19, researchers hope to identify patient factors that make them more likely to require ICU-level care, and whether ECMO can improve their outcomes.
Having patients on ECMO can be labor- and resource-intensive, Dr. Thompson said. It requires a dedicated nurse for each patient and extra equipment and monitoring. Dr. Thompson noted that in the 2009 H1N1 -- commonly known as swine flu -- outbreak, ECMO was a life-saving tool for many, with patients averaging one week on the machine. COVID-19 patients on ECMO appear to require long periods of support, averaging three weeks per patient. Some ICUs around the world have even reported patients on ECMO for eight weeks.
Nebraska Medicine has placed three COVID-19 patients on ECMO during the pandemic, including this 32-year-old man who spent more than a month in the ICU after testing positive for COVID-19. Information derived from this case and cases like it at Nebraska Medicine will contribute to the global study.
It’s good to hear that our brightest minds are successful in developing supportive care strategies to improve outcomes for those most seriously affected by the corona virus.