Your browser doesn't support javascript.
Extracorporeal Membrane Oxygenation Therapy for Critically Ill Coronavirus Disease 2019 Patients in Wuhan, China: A Retrospective Multicenter Cohort Study.
Fang, Jing; Li, Rui; Chen, Yue; Qin, Juan-Juan; Hu, Ming; Huang, Chao-Lin; Cheng, Lin; He, Yi; Li, Yi; Zhou, Qiang; Zhou, Dai-Xing; Huang, Fei; Lei, Fang; Yang, Bo; Chen, Jun; Deng, Hong-Ping; Yuan, Yu-Feng; Xia, Jia-Hong; Wan, Song; Li, Hong-Liang; Wei, Xiang.
  • Fang J; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Li R; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, 430030, China.
  • Chen Y; NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, 430030, China.
  • Qin JJ; Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, 430030, China.
  • Hu M; National Public Health Event Medical Center, National Health Commission of the People's Republic of China, Wuhan, 430030, China.
  • Huang CL; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Cheng L; Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, 430030, China.
  • He Y; NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, 430030, China.
  • Li Y; Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, 430030, China.
  • Zhou Q; National Public Health Event Medical Center, National Health Commission of the People's Republic of China, Wuhan, 430030, China.
  • Zhou DX; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Huang F; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
  • Lei F; Basic Medical School, Wuhan University, Wuhan, 430071, China.
  • Yang B; Department of Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, 430030, China.
  • Chen J; Wuhan Jinyintan Hospital, Wuhan, 430023, China.
  • Deng HP; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Yuan YF; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Xia JH; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Wan S; Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Li HL; Department of Intensive Critical Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • Wei X; Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci ; 41(1): 1-13, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1081528
ABSTRACT
Currently, little in-depth evidence is known about the application of extracorporeal membrane oxygenation (ECMO) therapy in coronavirus disease 2019 (COVID-19) patients. This retrospective multicenter cohort study included patients with COVID-19 at 7 designated hospitals in Wuhan, China. The patients were followed up until June 30, 2020. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with unsuccessful ECMO weaning. Propensity score matching was used to match patients who received veno-venous ECMO with those who received invasive mechanical ventilation (IMV)-only therapy. Of 88 patients receiving ECMO therapy, 27 and 61 patients were and were not successfully weaned from ECMO, respectively. Additionally, 15, 15, and 65 patients were further weaned from IMV, discharged from hospital, or died during hospitalization, respectively. In the multivariate logistic regression analysis, a lymphocyte count ≤0.5×109/L and D-dimer concentration >4× the upper limit of normal level at ICU admission, a peak PaCO2 >60 mmHg at 24 h before ECMO initiation, and no tracheotomy performed during the ICU stay were independently associated with lower odds of ECMO weaning. In the propensity score-matched analysis, a mixed-effect Cox model detected a lower hazard ratio for 120-day all-cause mortality after ICU admission during hospitalization in the ECMO group. The presence of lymphocytopenia, higher D-dimer concentrations at ICU admission and hypercapnia before ECMO initiation could help to identify patients with a poor prognosis. Tracheotomy could facilitate weaning from ECMO. ECMO relative to IMV-only therapy was associated with improved outcomes in critically ill COVID-19 patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Curr Med Sci Year: 2021 Document Type: Article Affiliation country: S11596-021-2311-8

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Curr Med Sci Year: 2021 Document Type: Article Affiliation country: S11596-021-2311-8