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Clinical outcomes of severe COVID-19 patients receiving early VV-ECMO and the impact of pre-ECMO ventilator use.
Kunavarapu, Chandra; Yeramaneni, Samrat; Melo, Jairo; Sterling, Rachel K; Huskey, Lindsey C; Sears, Lindsay; Burch, Charles; Rodriguez, Steve M; Habib, Phillip J; Triana, Fernando; DellaVolpe, Jeffrey.
  • Kunavarapu C; Department of Advanced Heart Failure and Transplantation and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
  • Yeramaneni S; Sarah Cannon Research Institute, HCA Healthcare, Nashville, TN, USA.
  • Melo J; Department of Critical Care Medicine and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
  • Sterling RK; Department of Critical Care Medicine and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
  • Huskey LC; Sarah Cannon Research Institute, HCA Healthcare, Nashville, TN, USA.
  • Sears L; Sarah Cannon Research Institute, HCA Healthcare, Nashville, TN, USA.
  • Burch C; Department of Critical Care Medicine and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
  • Rodriguez SM; Department of Advanced Heart Failure and Transplantation and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
  • Habib PJ; Department of Advanced Heart Failure and Transplantation and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
  • Triana F; Department of Cardiovascular Diseases, Methodist Health System, San Antonio, TX, USA.
  • DellaVolpe J; Department of Critical Care Medicine and Adult ECMO Program, Methodist Health System, San Antonio, TX, USA.
Int J Artif Organs ; 44(11): 861-867, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1526574
ABSTRACT
Acute respiratory distress syndrome (ARDS) in COVID-19 patients is associated with poor clinical outcomes and high mortality rates, despite the use of mechanical ventilation. Veno-Venous Extracorporeal membrane Oxygenation (VV-ECMO) in these patients is a viable salvage therapy. We describe clinical outcomes and survival rates in 52 COVID-19 patients with ARDS treated with early VV-ECMO at a large, high-volume center ECMO program. Outcomes included arterial blood gases, respiratory parameters, inflammatory markers, adverse events, and survival rates. Patients' mean age was 47.8 ± 12.1 years, 33% were female, and 75% were Hispanic. At the end of study period, 56% (n = 29) of the patients survived and were discharged and 44% (n = 23) of the patients expired. Survival rate was 75.0% (9 out of 12) in patients placed on ECMO prior to mechanical ventilation. Longer duration on mechanical ventilation prior to ECMO intervention was associated with a 31% (aOR = 1.31, 95% CI, 1.00-1.70) increased odds of mortality after adjusting for age, gender, BMI, number of comorbid conditions, and post-ECMO ventilator days. Early and effective ECMO intervention in critical ill COVID-19 patients might be a valuable strategy in critical care settings to increase their odds of survival.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Int J Artif Organs Year: 2021 Document Type: Article Affiliation country: 03913988211047604

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Int J Artif Organs Year: 2021 Document Type: Article Affiliation country: 03913988211047604