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COVID-19 outcomes of venovenous extracorporeal membrane oxygenation for acute respiratory failure vs historical cohort of non-COVID-19 viral infections.
Dave, Sagar B; Rabinowitz, Ronald; Shah, Aakash; Tabatabai, Ali; Galvagno, Samuel M; Mazzeffi, Michael A; Rector, Raymond; Kaczorowski, David J; Scalea, Thomas M; Menaker, Jay.
  • Dave SB; Department of Emergency Medicine, Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA.
  • Rabinowitz R; Department of Medicine, Program in Trauma, R Adams Cowley Shock Trauma Center, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Shah A; Department of Surgery, Division of Cardiac Surgery, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Tabatabai A; Department of Medicine, Division of Pulmonary and Critical Care, Program in Trauma, R Adams Cowley Shock Trauma Center, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Galvagno SM; Department of Anesthesiology, Program in Trauma, R Adams Cowley Shock Trauma Center, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Mazzeffi MA; Department of Anesthesiology and Critical Care Medicine, 43989George Washington School of Medicine and Health Sciences, Washington, DC, USA.
  • Rector R; Perfusion Services, 21668University of Maryland Medical Center, Baltimore, MD, USA.
  • Kaczorowski DJ; Department of Cardiothoracic Surgery, 6595University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Scalea TM; Department of Surgery, Program in Trauma, R Adams Cowley Shock Trauma Center, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Menaker J; Department of Surgery, Johns Hopkins Medicine, 23234Howard County General Hospital, Columbia, MD, USA.
Perfusion ; : 2676591221105603, 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-1874962
ABSTRACT

INTRODUCTION:

Veno-venous extracorporeal membrane oxygenation (VV ECMO) has become a support modality for patients with acute respiratory failure refractory to standard therapies. VV ECMO has been increasingly used during the current COVID-19 pandemic for patients with refractory respiratory failure. The object of this study was to evaluate the outcomes of VV ECMO in patients with COVID-19 compared to patients with non-COVID-19 viral infections.

METHODS:

We retrospectively reviewed all patients supported with VV ECMO between 8/2014 and 8/2020 whose etiology of illness was a viral pulmonary infection. The primary outcome of this study was to evaluate in-hospital mortality. The secondary outcomes included length of ECMO course, ventilator duration, hospital length of stay, incidence of adverse events through ECMO course.

RESULTS:

Eighty-nine patients were included (35 COVID-19 vs 54 non-COVID-19). Forty (74%) of the non-COVID-19 patients had influenza virus. Prior to cannulation, COVID-19 patients had longer ventilator duration (3 vs 1 day, p = .003), higher PaCO2 (64 vs 53 mmHg, p = .012), and white blood cell count (14 vs 9 ×103/µL, p = .004). Overall in-hospital mortality was 33.7% (n = 30). COVID-19 patients had a higher mortality (49% vs. 24%, p = .017) when compared to non-COVID-19 patients. COVID-19 survivors had longer median time on ECMO than non-COVID-19 survivors (24.4 vs 16.5 days p = .03) but had a similar hospital length of stay (HLOS) (41 vs 48 Extracorporeal Membrane Oxygenationdays p = .33).

CONCLUSION:

COVID-19 patients supported with VV ECMO have a higher mortality than non-COVID-19 patients. While COVID-19 survivors had significantly longer VV ECMO runs than non-COVID-19 survivors, HLOS was similar. This data add to a growing body of literature supporting the use of ECMO for potentially reversible causes of respiratory failure.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Perfusion Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: 02676591221105603

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Perfusion Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: 02676591221105603