The ProtekDuo in ECMO configuration for ARDS secondary to COVID-19: A systematic review

Int J Artif Organs. 2023 Feb;46(2):93-98. doi: 10.1177/03913988221142904. Epub 2022 Dec 10.

Abstract

Objective: Assessment of the results of the ProtekDuo cannula applied for dedicated right ventricular support with oxygenator in ARDS secondary to COVID-19.

Methods: Systematic literature search in NHS library, Medline (Pubmed) and EMBASE using appropriate keywords as well as PICOS and PRISMA approach.

Results: 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.

Conclusion: 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.

Keywords: ECLS; ProtekDuo; RVAD; extracorporeal life support; extracorporeal membrane oxygenation; percutaneous; right ventricular assist device.

Publication types

  • Systematic Review

MeSH terms

  • Acute Kidney Injury* / therapy
  • COVID-19*
  • Cannula
  • Extracorporeal Membrane Oxygenation* / methods
  • Humans
  • Respiratory Distress Syndrome* / therapy