Venovenous extracorporeal membrane oxygenation for treating very severe pneumonia in Aotearoa New Zealand: a 16-year experience
New Zealand Medical Journal
; 134(1542):56-66, 2021.
Article
in English
| EMBASE | ID: covidwho-1766672
ABSTRACT
AIM:
We sought to describe the aetiology, demographics and outcomes of patients with pneumonia undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO) in Aotearoa New Zealand.METHODS:
Retrospective observational study.RESULTS:
Between January 2004 and August 2020, 133 patients underwent VV-ECMO for pneumonia. This VV-ECMO cohort is representative of the geographic and ethnic distribution of the population of Aotearoa New Zealand. Six-month survival was 85/133 (64%). A primary viral aetiology was identified in 63/133 cases (47%) with bacterial co-infection present in 34/63 viral pneumonias (54%). Primary bacterial pneumonia was identified in 48/133 cases (36%). Twenty-three (17%) of 133 patients developed necrotising pneumonia. The most commonly identified microorganisms were influenza A, Staphylococcus aureus and Streptococcus pneumoniae. Infection with Staphylococcus aureus or Streptococcus species was strongly associated with necrotising pneumonia (OR 10.18, 95% CI 3.52–37.13, P<0.0001). Necrotising pneumonia was more common in Māori and Pacific Peoples than in other ethnic groups (OR 3.08, 95% CI 1.16–7.96, P=0.02).DISCUSSION:
Outcomes from VV-ECMO for pneumonia in Aotearoa New Zealand are comparable to large international series. Although the use of VV-ECMO was matched to the ethnic distribution of the population of Aotearoa New Zealand, Māori may have reduced access because they have higher rates of pneumonia than non-Māori.
culture medium; hypertensive factor; adenovirus infection; adult; article; aspergillosis; asthma; bacterial pneumonia; bacterium culture; cardiovascular disease; caseation; chickenpox; cohort analysis; computer assisted tomography; coronavirus disease 2019; cytomegalovirus infection; data extraction; diabetes mellitus; Escherichia coli; Escherichia coli infection; female; group A streptococcal infection; Haemophilus infection; Haemophilus influenzae; Haemophilus parainfluenzae; human; Human metapneumovirus infection; influenza A; Influenza A virus (H1N1); influenza B; Klebsiella pneumoniae; Klebsiella pneumoniae infection; Legionella longbeachae; Legionella pneumophila; legionnaire disease; lung parenchyma; major clinical study; male; mental disease; microbiological examination; multiple organ failure; Mycoplasma pneumonia; Mycoplasma pneumoniae; necrotizing pneumonia; observational study; parvovirus infection; pneumococcal infection; pneumonia; Pseudomonas aeruginosa; Pseudomonas infection; radiography; retrospective study; Severe acute respiratory syndrome coronavirus 2; Staphylococcus aureus; Staphylococcus aureus infection; Streptococcus pneumoniae; Streptococcus pyogenes; tuberculosis; veno-arterial ECMO
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
New Zealand Medical Journal
Year:
2021
Document Type:
Article
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