Complications and causes of death of patients with COVID-19 requiring extracorporeal respiratory support. A subanalysis of the ECMOVIBER study
Perfusion
; 36(1 SUPPL):35, 2021.
Article
in English
| EMBASE | ID: covidwho-1264067
ABSTRACT
Objective:
To describe the most frequent complications and causes of death of COVID-19 patients requiring extracorporeal respiratory support.Methods:
Descriptive analysis of the ECMOVIBER registry, including 25 ECMO centers in Spain (23) and Portugal (2). All adult (>18 years old) COVID-19 patients requiring veno-venous ECMO between 1st March and 1st December 2020 were included. The follow up period ended 1st December 2020. Demographic data, comorbidities and complications during ECMO [acute kidney injury, ventilator associated pneumonia (VAP), hemorrhage and thrombosis] were recorded. Results are described using median (interquartile range) or frequency (percentage).Results:
A total of 316 patients [age 55 (47-60), 253 (80%) male] were included. Only 21 (7%) patients had prior respiratory disease and 12 (4%) chronic kidney disease. One hundred and thirty-one (41%) patients received anticoagulation prior to cannulation and 94 (30%) suffered concomitant bacterial coinfection prior to ECMO initiation. Eighty-two (26%) patients developed acute kidney injury of which 73 (89%) required continuous renal replacement therapy;50 (16%) suffered at least one thrombotic episode during the extracorporeal support (47 deep venous thrombosis, 3 pulmonary embolism) and 41 (13%) presented haemorrhagic shock. In 109 (34%) patients clots in the circuit were identified and 20 of them (18%) required at least one circuit change. The most frequent infectious complication was VAP [154 patients (49%)]. One hundred and twenty (38%) patients died on ECMO and 9 (3%) after decannulation. The most frequently reported causes of death were multiorgan dysfunction [37 (29%)], persistent respiratory failure due to COVID- 19 [23 (18%)] and septic shock [20 (15%)]. Death during cannulation occurred in 11 cases (3% of the total population).Conclusions:
Complications during extracorporeal respiratory support in COVID-19 patients are frequent. VAP may complicate up to half of the cases. Persistent COVID-19 was the cause of death of almost one fifth of the population.
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Perfusion
Year:
2021
Document Type:
Article
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