Coronavirus 2019 (COVID-19) venovenous extracorporeal oxygenation: Single community hospital results and insights.

BACKGROUND: The role of extracorporeal membrane oxygenation (ECMO) for patients with refractory respiratory failure due to coronavirus 2019 (COVID-19) is still unclear even now over a year into the pandemic. ECMO is becoming more commonplace even at smaller community hospitals. While the advantages of venovenous (VV) ECMO in acute respiratory distress syndrome (ARDS) from COVID-19 have not been fully determined, we believe the benefits outweighed the risks in our patient population. Here we describe all patients who underwent VV ECMO at our center. METHODS: All patients placed on ECMO at our center since the beginning of the pandemic, May 5, 2020, until February 20, 2021 were included in our study. All patients placed on ECMO during the time period described above were followed until discharge or death. The primary endpoint was in-hospital death. Secondary outcomes included discharge disposition, that is, whether patients were sent to a long-term acute care center (LTAC), inpatient rehabilitation, or went directly home. RESULTS: A total of 41 patients were placed on VV ECMO for refractory acute respiratory failure. Survival to discharge, the primary end point, was 63.4% (26/41). Inpatient mortality was 36.6% (15/41). CONCLUSIONS: We show here that a successful high-volume VV ECMO program for ARDS is achievable at even a medium-size community hospital. We think our success can be replicated by most small- and medium-size community hospitals with cardiothoracic surgery programs and intensivist teams.

Size-dependent molecule-like to plasmonic transition in water-soluble glutathione stabilized gold nanomolecules.

A size-dependent transition from molecule-like to plasmonic behaviour is demonstrated in the case of water soluble Au:SG nanomolecules. This was achieved using PAGE separation of smaller and larger nanomolecules, resulting in an unprecedented 26 bands, in a wide-range from 10's to 1000's of Au-atoms. PAGE separation of larger plasmonic nanomolecules is demonstrated for the first time. High resolution ESI-MS, with isotopic resolution, of smaller nanoparticles is reported, including the first time report of Au43(SG)26. This report will aid in the fundamental understanding of size-dependent properties of nanomolecules. The synthetic procedure employs a green approach with non-toxic chemicals and processes. The water solubility, non-toxicity and biocompatibility will lead to applications in biomedicine.