Analysis of COVID-19 Patients With Acute Respiratory Distress Syndrome Managed With Extracorporeal Membrane Oxygenation at US Academic Centers.
Ann Surg
; 274(1): 40-44, 2021 07 01.
Article
in English
| MEDLINE | ID: covidwho-1177358
ABSTRACT
OBJECTIVE:
This study analyzed the outcomes of COVID-19 patients with ARDS who were managed with extracorporeal membrane oxygenation (ECMO) across 155 US academic centers. SUMMARY BACKGROUND DATA ECMO has been utilized in COVID-19 patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia. Early case series with the use of ECMO in these patients reported high mortality exceeding 90%.METHODS:
Using ICD-10 codes, data of patients with COVID-19 with ARDS, managed with ECMO between April and September 2020, were analyzed using the Vizient clinical database. Outcomes measured included in-hospital mortality, hospital and ICU length of stay, and direct cost. For comparative purposes, the outcome of a subset of COVID-19 patients aged between 18 and 64âyears and managed with versus without ECMO were examined.RESULTS:
1,182 patients with COVID-19 and ARDS received ECMO. In-hospital mortality was 45.9%, mean length of stay was 36.8â±â24.9âdays, and mean ICU stay was 29.1â±â17.3âdays. In-hospital mortality according to age group was 25.2% for 1 to 30âyears; 42.2% for 31 to 50âyears; 53.2% for 51 to 64âyears; and 73.7% for ≥65âyears. A subset analysis of COVID-19 patients, aged 18 to 64âyears with ARDS requiring mechanical ventilation and managed with (n = 1113) vs without (n = 16,343) ECMO, showed relatively high in-hospital mortality for both groups (44.6% with ECMO vs 37.9% without ECMO).CONCLUSIONS:
In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Extracorporeal Membrane Oxygenation
/
Academic Medical Centers
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Humans
/
Infant
/
Middle aged
/
Young adult
Country/Region as subject:
North America
Language:
English
Journal:
Ann Surg
Year:
2021
Document Type:
Article
Affiliation country:
SLA.0000000000004870
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