Two physicians from the University of Arizona are among the authors of a new research paper detailing the best practice guidelines for patients in intensive care units requiring advanced life-saving therapies due to COVID-19.

Regents Professor Marvin Slepian and assistant professor Christian Bime of the Department of Medicine drew on their years of experience to help write “Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations from ASAIO” just published from the American Society for Artificial Internal Organs. The paper appears in the latest issues of the ASAIO Journal as well as the journal Circulation: Heart Failure.
Described as a "Living Working Document," the paper will be continually updated on the ASAIO website as new information on COVID-19 and care for critically ill patients comes to light.

“This paper is meant to be a living document to advance best practices for widespread dissemination,” Dr. Slepian said in a press release. “The strategy of the living document is that while U.S. experts are providing their best practice recommendations, their actual experience with COVID-19 will evolve with additional frontline cases around the globe."

As the current ASAIO president, Slepian assembled a group of cardiac, cardiovascular, and pulmonary specialists to put together a recommendation of best practices for this paper. Other contributing researchers hail from Harvard Medical School, University of Texas, and the Vita-Salute San Raffaele University in Italy.

“A large number of patients hospitalized for COVID-19 develop severe respiratory compromise,” Slepian said. “While many are treated successfully with ventilators, a significant number deteriorate, needing enhanced methods of oxygenation. Beyond lung deterioration, a subgroup of these failing patients develop heart dysfunction with acute heart failure.”
According to Slepian, the best current life-saving technology for these critical COVID-19 patients is an advanced treatment known as extracorporeal membrane oxygenation or ECMO. With this treatment, mechanical circulatory support systems "essentially replace heart and lung function."

According to the paper's abstract, although ECMO and other mechanical cardiopulmonary support systems are increasingly being utilized to treat respiratory and circulatory failure, their role and efficacy "as support modalities in the present pandemic are unclear. We review the rapidly changing epidemiology, pathophysiology, emerging therapy, and clinical outcomes of COVID-19; and based on these data and previous experience with artificial cardiopulmonary support strategies, particularly in the setting of infectious diseases, provide consensus recommendations from ASAIO."