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American Society For Artificial Internal Organs (ASAIO) Outlines Best Practices For Advanced Pulmonary And Cardiac Support Of COVID-19 Patients

A Living Working Document, Co-Authored by University of Arizona Regents' Professor & ASAIO President Marvin J. Slepian, MD, Published in ASAIO Journal & Circulation: Heart Failure


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ASAIO

May 04, 2020, 07:00 ET

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TUCSON, Ariz., May 4, 2020 /PRNewswire/ -- The American Society for Artificial Internal Organs (ASAIO) has outlined best practices for advanced pulmonary and cardiac support of COVID-19 patients in a paper entitled "Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations from ASAIO — A Living Working Document" being published this month in the ASAIO Journal and Circulation: Heart Failure, a journal of the American Heart Association. The paper was co-authored by Marvin J. Slepian, MD, Director of the Arizona Center for Accelerated Biomedical Innovation at the University of Arizona and ASAIO President.

"A large number of patients hospitalized for COVID-19 develop severe respiratory compromise," stated Dr. Slepian, who is also Regents' Professor at the University of Arizona, Sarver Heart Center, College of Medicine – Tucson and College of Engineering. "While many are treated successfully with ventilators, a significant number deteriorate, needing enhanced methods of oxygenation. In addition, a subgroup of these failing patients develops heart dysfunction with acute heart failure.

"An advanced treatment method known as ECMO — extracorporeal membrane oxygenation — is the best lifesaving technology we have today," he continued. "Rapid placement of a mechanical circulatory support (MCS) coupled with oxygenators — is needed to essentially replace lung and heart functions."

ASAIO has been in the forefront of research and development of both the ECMO and MCS technologies, which are advanced therapeutic techniques practiced primarily at tertiary and referral medical centers around the United States by a highly skilled group of cardiac, cardiac surgical, pulmonary, and related specialists. ASAIO physicians, engineers, scientists and industry members have also been instrumental in advancing the clinical knowledge base and refining best practice skills needed to safely and effectively transfer these cutting-edge technologies into broader clinical use.

"The pandemic motivated us to move quickly to put together recommendations for best practices to facilitate widespread use of these lifesaving technologies in order to offset the destructive effects of COVID on the lungs and heart," said Dr. Slepian. He convened a group of leading international cardiac, cardiac surgical, and pulmonary specialists to compile the recommendations outlined in the paper. They developed the concept of a Living Working Document to allow these best practices to be expanded and refined as physicians actually experience being on the frontlines of COVID-19.

"As new insights, adaptations, and improvements emerge," explained Dr. Slepian, "we will rapidly publish them online as supplements and updates to the original document." In addition to publication, the paper will appear on the ASAIO Action portal, which allows physicians to share their experiences, comments and offer suggestions. Top advances will be added to the portal as they occur. "This will provide cardiac and pulmonary specialists with the ability to iterate and refine these lifesaving techniques through a collaborative worldwide effort," he concluded.

Co-authors of the paper are Bindu Akkanti, MD (University of Texas-Houston & Memorial Hermann-Texas Medical Center, Houston, TX), Christian Bime, MD (University of Arizona College of Medicine – Tucson and Banner – University Medicine, Tucson, AZ), Faisal H. Cheema, MD (University of Houston College of Medicine; Houston Heart, HCA Houston Healthcare, Houston, TX; HCA Research Institute, Nashville, TN), Aly el-Banayosy, MD (Integris Baptist Medical Center, Oklahoma City, OK), Steven P. Keller, MD, PhD (Brigham and Women's Hospital and Harvard Medical School, Boston, MA), Pranav Loyalka, MD (Houston Heart, HCA Houston Healthcare, Houston, TX), Federico Pappalardo, MD (Vita-Salute San Raffaele University, Milan, Italy), Keshava Rajagopal, MD, PhD (University of Houston College of Medicine; Houston Heart, HCA Houston Healthcare, Houston, TX), Mark S. Slaughter, MD (University of Louisville School of Medicine and Jewish Hospital, Louisville, KY), and Joseph B. Zwischenberger, MD (University of Kentucky College of Medicine and Medical Center, Lexington, KY).

The American Society for Artificial Internal Organs (ASAIO) has been in existence for close to 70 years, striving to save lives one medical device at a time. Its mission is to provide an international, collaborative forum promoting the development of innovative medical device technology at the nexus of science, engineering, and medicine. Its interdisciplinary membership is comprised of academia, clinicians, engineers, government agencies, industry, and the financial community. For more, visit: asaio.org/about/

The University of Arizona Sarver Heart Center's 160 members include faculty from cardiology, cardiothoracic surgery, pediatric cardiology, neurology, vascular surgery, radiology, endocrinology, emergency medicine, nursing, pharmacy and basic sciences. The Sarver Heart Center, which is affiliated with the UArizona College of Medicine – Tucson and UArizona Health Sciences, emphasizes a highly collaborative research environment, fostering innovative translational or "bench-to-bedside" research; dedicated to innovating lifesaving patient care. The academic mission of the Sarver Heart Center encompasses four fellowship programs in cardiovascular disease, interventional cardiology, advanced heart failure and transplant cardiology, and electrophysiology. For more information: heart.arizona.edu (Follow us: Facebook | Twitter | Instagram | YouTube).

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