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Extracorporeal membrane oxygenation in patients with COVID-19: 1-year experience.
Durak, Koray; Zayat, Rashad; Grottke, Oliver; Dreher, Michael; Autschbach, Rüdiger; Marx, Gernot; Marx, Nikolaus; Spillner, Jan; Kalverkamp, Sebastian; Kersten, Alexander.
  • Durak K; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • Zayat R; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • Grottke O; Department of Anesthesiology, RWTH University Hospital Aachen, Aachen, Germany.
  • Dreher M; Department of Pneumology and Intensive Care Medicine, RWTH University Hospital Aachen, Aachen, Germany.
  • Autschbach R; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • Marx G; Department of Intensive Care and Intermediate Care Medicine, RWTH University Hospital Aachen, Aachen, Germany.
  • Marx N; Department of Cardiology, Angiology, and Intensive Care, RWTH University Hospital Aachen, Aachen, Germany.
  • Spillner J; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • Kalverkamp S; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • Kersten A; Department of Cardiology, Angiology, and Intensive Care, RWTH University Hospital Aachen, Aachen, Germany.
J Thorac Dis ; 13(10): 5911-5924, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1527068
ABSTRACT

BACKGROUND:

Extracorporeal membrane oxygenation (ECMO) in patients with coronavirus disease 2019 (COVID-19) showed reasonable outcomes. However, recent studies indicated a negative trend and analysis is needed.

METHODS:

Baseline characteristics, laboratory parameters, and outcomes of ECMO-supported patients with COVID-19 were analyzed in a retrospective single-center study. We included hospital admissions until February 28, 2021; patients were followed until discharge/death. Eventually, we compared data between patients hospitalized before and after September 1, 2020.

RESULTS:

Median age of patients treated with ECMO (n=39) was 56 years; most patients were males (n=28, 72%). Median mechanical ventilation time (prior to ECMO) was 6 days, while the median ECMO duration was 19 days. Overall survival rate was 41%. In the sub-analysis, survival until discharge in the first and second epidemic waves was 53% (n=19) and 30% (n=20), respectively (P=0.2). At baseline, compared with patients of the first wave, those of the second wave had higher median body mass index (28.2 vs. 31.1 kg/m2, respectively, P=0.02), bicarbonate (27 vs. 31.8 mmol/L, respectively, P=0.033), plasma free hemoglobin (36 vs. 58 mg/L, respectively, P=0.013), alanine aminotransferase (33 vs. 52 U/L, respectively, P=0.018), and pH (7.29 vs. 7.42, respectively, P=0.005), lower rate of pulmonary hypertension (32% vs. 0%, respectively, P=0.008), lower positive end-expiratory pressure (14 vs. 12 cmH2O, respectively, P=0.04), longer median ECMO duration (16 vs. 24.5 days, respectively, P=0.074), and more frequent major bleeding events (42% vs. 80%, respectively, P=0.022).

CONCLUSIONS:

ECMO-supported patients with COVID-19 had an overall survival rate of 41%. Similar to international registries, we observed less favorable outcomes during the second wave. Further research is needed to confirm this signal and find predictors for mortality.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: J Thorac Dis Year: 2021 Document Type: Article Affiliation country: Jtd-21-971

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: J Thorac Dis Year: 2021 Document Type: Article Affiliation country: Jtd-21-971