TUCSON, Ariz. – University of Arizona Regents’ Professor Marvin Slepian, MD, and assistant professor Christian Bime, MD, are among multiple co-authors of a paper, “Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations from ASAIO – A Living Working Document,” just published from the American Society for Artificial Internal Organs (ASAIO).
The paper appears in the latest issues of the ASAIO Journal as well as the journal Circulation: Heart Failure as a work in progress and will be continually updated at the ASAIO website as new information is evaluated with regard to the novel coronavirus and care for critically ill patients, according to Dr. Slepian, current ASAIO president and the first ever elected to serve a second term.
“A large number of patients hospitalized for COVID-19 develop severe respiratory compromise,” stated Dr. Slepian. “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.”
A cardiologist by training, Dr. Slepian is a UArizona professor in the College of Medicine – Tucson and College of Engineering who also is a member of the Sarver Heart Center and BIO5 Institute and founding director of the Arizona Center for Accelerated Biomedical Innovation (ACABI), a university-wide “creativity engine” or “inventors’ workshop” that helps faculty members and students develop and amplify ideas into practical innovations and products to improve life and health. He also is past-president of the International Society for Mechanical Circulatory Support.
“For these patients an advanced treatment method known as ECMO – extracorporeal membrane oxygenation, is the best life-saving technology we have today,” he continued. “Here, rapid placement of mechanical circulatory support (MCS) system – support and augmentation pumps, with ECMO, is needed – to essentially replace heart and lung function.”
These approaches of ECMO and MCS are advanced therapeutic techniques practiced largely at U.S. tertiary and referral medical centers via a skilled group of cardiac, cardiovascular surgical, pulmonary and related specialists. Knowledge is lacking, however, as to the intricacies and best practices of these methods for those not performing them on a routine basis.
ASAIO, a society of physicians, engineers, scientists and industry, has been at the forefront of developing both ECMO and MCS technologies – developing the systems, the clinical knowledge base and refining best practice skills needed to move these technologies safely and effectively into broader clinical use.
Dr. Slepian has assembled a group of leading cardiac, cardiovascular surgical and pulmonary specialists from around the world to put together a recommendation of best practices paper to facilitate rapid widespread use of this life-saving technology in response to COVID-19. In addition to publication, the paper appears 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. Thus, cardiac and pulmonary specialists will have a means of refining these advanced lifesaving techniques via collaborative interactive efforts worldwide.
Dr. Bime, the other UArizona co-author on the paper, is an assistant professor in the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine at the College of Medicine – Tucson and director of the medical intensive care unit at Banner – University Medical Center Tucson.
Nancy Sweitzer, MD, PhD, who is the Sarver Heart Center director, chief of the Division of Cardiology and a professor of medicine at the College of Medicine – Tucson, is the editor-in-chief of Circulation: Heart Failure, a publication of the American Heart Association.
“This paper is meant to be a living document to advance best practices for widespread dissemination,” Dr. Slepian said. “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 new insights, new adaptations and improvements emerge, these advances will rapidly be published and put on line subsequently as supplement/updates to the present paper.”
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Marvin Slepian, MD
NOTE: Images and graphic available upon request.
About the American Society of Artificial Internal Organs
The American Society for Artificial Internal Organs (ASAIO) is a global society in existence for nearly 70 years. 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. Learn more at: asaio.org
About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).