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Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation-A Retrospective International Multicenter Study.
Supady, Alexander; DellaVolpe, Jeff; Taccone, Fabio Silvio; Scharpf, Dominik; Ulmer, Matthias; Lepper, Philipp M; Halbe, Maximilian; Ziegeler, Stephan; Vogt, Alexander; Ramanan, Raj; Boldt, David; Stecher, Stephanie-Susanne; Montisci, Andrea; Spangenberg, Tobias; Marggraf, Olivier; Kunavarapu, Chandra; Peluso, Lorenzo; Muenz, Sebastian; Buerle, Monica; Nagaraj, Naveen G; Nuding, Sebastian; Toma, Catalin; Gudzenko, Vadim; Stemmler, Hans Joachim; Pappalardo, Federico; Trummer, Georg; Benk, Christoph; Michels, Guido; Duerschmied, Daniel; von Zur Muehlen, Constantin; Bode, Christoph; Kaier, Klaus; Brodie, Daniel; Wengenmayer, Tobias; Staudacher, Dawid L.
  • Supady A; Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
  • DellaVolpe J; Department of Cardiology and Angiology I, Heart Center, University of Freiburg, 79106 Freiburg, Germany.
  • Taccone FS; Heidelberg Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany.
  • Scharpf D; Methodist Hospital, San Antonio, TX 78229, USA.
  • Ulmer M; Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.
  • Lepper PM; SLK-Hospital Heilbronn, 74078 Heilbronn, Germany.
  • Halbe M; RKH Hospital Ludwigsburg, 71640 Ludwigsburg, Germany.
  • Ziegeler S; Department of Internal Medicine V-Pneumology, Allergology and Critical Care Medicine, Saarland University Medical Center and University of Saarland, D-66421 Homburg, Germany.
  • Vogt A; Heart Center, University Hospital Zurich, 8006 Zurich, Switzerland.
  • Ramanan R; Department of Anesthesiology, Intensive Care Medicine and Pain Management, Hospital Ibbenbueren, 49477 Ibbenbueren, Germany.
  • Boldt D; Department of Medicine III, University Clinic Halle (Saale), 06097 Halle (Saale), Germany.
  • Stecher SS; University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA 15213, USA.
  • Montisci A; UCLA Healthcare System, Los Angeles, CA 90095, USA.
  • Spangenberg T; Medical Department II, LMU Hospital Munich, 80331 Munich, Germany.
  • Marggraf O; Istituto Clinico Sant'Ambrogio, University of Milan, 20149 Milan, Italy.
  • Kunavarapu C; Department of Cardiology, Angiology and Intensive Care, Marien Hospital Hamburg, 22087 Hamburg, Germany.
  • Peluso L; Asklepios Clinic North, 22417 Hamburg, Germany.
  • Muenz S; Methodist Hospital, San Antonio, TX 78229, USA.
  • Buerle M; Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.
  • Nagaraj NG; SLK-Hospital Heilbronn, 74078 Heilbronn, Germany.
  • Nuding S; RKH Hospital Ludwigsburg, 71640 Ludwigsburg, Germany.
  • Toma C; Heart Center, University Hospital Zurich, 8006 Zurich, Switzerland.
  • Gudzenko V; Department of Medicine III, University Clinic Halle (Saale), 06097 Halle (Saale), Germany.
  • Stemmler HJ; University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA 15213, USA.
  • Pappalardo F; UCLA Healthcare System, Los Angeles, CA 90095, USA.
  • Trummer G; Medical Department III, LMU Hospital Munich, 80331 Munich, Germany.
  • Benk C; Department of Anesthesia and Intensive Care, IRCCS ISMETT, UPMC Italy, 90127 Palermo, Italy.
  • Michels G; Department of Cardiovascular Surgery, Heart Center, University of Freiburg, 79106 Freiburg, Germany.
  • Duerschmied D; Department of Cardiovascular Surgery, Heart Center, University of Freiburg, 79106 Freiburg, Germany.
  • von Zur Muehlen C; Department of Acute and Emergency Care, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany.
  • Bode C; Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
  • Kaier K; Department of Cardiology and Angiology I, Heart Center, University of Freiburg, 79106 Freiburg, Germany.
  • Brodie D; Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
  • Wengenmayer T; Department of Cardiology and Angiology I, Heart Center, University of Freiburg, 79106 Freiburg, Germany.
  • Staudacher DL; Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
Membranes (Basel) ; 11(3)2021 Feb 27.
Article in English | MEDLINE | ID: covidwho-1121711
Semantic information from SemMedBD (by NLM)
1. Forecast of outcome TREATS COVID-19
Subject
Forecast of outcome
Predicate
TREATS
Object
COVID-19
2. Forecast of outcome TREATS Patients
Subject
Forecast of outcome
Predicate
TREATS
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Venovenous ECMO TREATS COVID-19
Subject
Venovenous ECMO
Predicate
TREATS
Object
COVID-19
5. Venovenous ECMO TREATS Patients
Subject
Venovenous ECMO
Predicate
TREATS
Object
Patients
6. Venovenous ECMO TREATS Severe Acute Respiratory Syndrome
Subject
Venovenous ECMO
Predicate
TREATS
Object
Severe Acute Respiratory Syndrome
7. Venovenous ECMO TREATS Cohort
Subject
Venovenous ECMO
Predicate
TREATS
Object
Cohort
8. Forecast of outcome TREATS COVID-19
Subject
Forecast of outcome
Predicate
TREATS
Object
COVID-19
9. Forecast of outcome TREATS Patients
Subject
Forecast of outcome
Predicate
TREATS
Object
Patients
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Venovenous ECMO TREATS COVID-19
Subject
Venovenous ECMO
Predicate
TREATS
Object
COVID-19
12. Venovenous ECMO TREATS Patients
Subject
Venovenous ECMO
Predicate
TREATS
Object
Patients
13. Venovenous ECMO TREATS Severe Acute Respiratory Syndrome
Subject
Venovenous ECMO
Predicate
TREATS
Object
Severe Acute Respiratory Syndrome
14. Venovenous ECMO TREATS Cohort
Subject
Venovenous ECMO
Predicate
TREATS
Object
Cohort
ABSTRACT
The role of veno-venous extracorporeal membrane oxygenation therapy (V-V ECMO) in severe COVID-19 acute respiratory distress syndrome (ARDS) is still under debate and conclusive data from large cohorts are scarce. Furthermore, criteria for the selection of patients that benefit most from this highly invasive and resource-demanding therapy are yet to be defined. In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival.

METHODS:

This is an investigator-initiated retrospective non-interventional international multicenter registry study (NCT04405973, first registered 28 May 2020). In 127 patients treated with V-V ECMO at 15 centers in Germany, Switzerland, Italy, Belgium, and the United States, we calculated the Sequential Organ Failure Assessment (SOFA) Score, Simplified Acute Physiology Score II (SAPS II), Acute Physiology And Chronic Health Evaluation II (APACHE II) Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) Score, Predicting Death for Severe ARDS on V­V ECMO (PRESERVE) Score, and 30-day survival.

RESULTS:

In our study cohort which enrolled 127 patients, overall 30-day survival was 54%. Median SOFA, SAPS II, APACHE II, RESP, and PRESERVE were 9, 36, 17, 1, and 4, respectively. The prognostic accuracy for all these scores (area under the receiver operating characteristic-AUROC) ranged between 0.548 and 0.605.

CONCLUSIONS:

The use of scores for the prediction of mortality cannot be recommended for treatment decisions in severe COVID-19 ARDS undergoing V-V ECMO; nevertheless, scoring results below or above a specific cut-off value may be considered as an additional tool in the evaluation of prognosis. Survival rates in this cohort of COVID-19 patients treated with V­V ECMO were slightly lower than those reported in non-COVID-19 ARDS patients treated with V-V ECMO.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Risk factors Language: English Year: 2021 Document Type: Article Affiliation country: Membranes11030170

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Risk factors Language: English Year: 2021 Document Type: Article Affiliation country: Membranes11030170