Nazih Zuhdi Transplant Institute, Advanced Cardiac and Specialty Critical Care, Oklahoma City, OK, USA.
Department of Anaesthesiology and Intensive Care Medicine, Philipps University, Marburg, Germany.
Int J Artif Organs. 2023 Feb;46(2):93-98. doi: 10.1177/03913988221142904. Epub 2022 Dec 10.
Assessment of the results of the ProtekDuo cannula applied for dedicated right ventricular support with oxygenator in ARDS secondary to COVID-19.
Systematic literature search in NHS library, Medline (Pubmed) and EMBASE using appropriate keywords as well as PICOS and PRISMA approach.
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.
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.
评估 ProtekDuo 导管在 COVID-19 继发急性呼吸窘迫综合征（ARDS）中与氧合器联合用于右心室专用支持的结果。
在 NHS 图书馆、Medline（PubMed）和 EMBASE 中使用适当的关键词进行系统文献检索，以及采用 PICOS 和 PRISMA 方法。
在 285 篇已发表的文章中，有 5 篇符合搜索标准，并被纳入本综述。总共 194 例 COVID-19 继发 ARDS 患者接受了 ProtekDuo 导管的放置，以建立呼吸[静脉-静脉体外膜肺氧合（V-V ECMO）]和右心室支持的联合治疗。在这五项研究中，使用 ProtekDuo 导管治疗的患者的生存率在 59%至 89%之间，与有创通气组或与双部位 V-V ECMO 或其他双腔 ECMO 导管相比，生存率有显著提高。有一项研究侧重于脱机和停止呼吸机支持，在 100%的 ProtekDuo 患者中可以实现这一点。当使用 ProtekDuo 时，可以显示出急性肾损伤（AKI）发生率降低和持续肾脏替代治疗（CRRT）的使用减少。
在 COVID-19 ARDS 中，只有有限的文献可用于 ProtekDuo 在 V-P ECMO 配置中的应用，应谨慎解释。与其他呼吸支持模式相比，ProtekDuo 在死亡率、AKI 和 CRRT 方面的数据提示其具有较低的发生率。
