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Rising Mortality in Coronavirus-19 Patients Supported With Extracorporeal Membrane Oxygenation.
Rando, Hannah J; Fassbinder, Marius; Velez, Ana K; Etchill, Eric W; Holmes, Sari D; Whitman, Glenn; Cho, Sung-Min; Keller, Steven; Kim, Bo Soo.
  • Rando HJ; From the Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Fassbinder M; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Velez AK; From the Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Etchill EW; From the Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Holmes SD; From the Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Whitman G; From the Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Cho SM; Division of Neuroscience Critical Care, Department of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Keller S; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Kim BS; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
ASAIO J ; 69(3): 254-259, 2023 03 01.
Article in English | MEDLINE | ID: covidwho-2277726
ABSTRACT
We aimed to describe practice patterns and outcomes in patients with extracorporeal membrane oxygenation (ECMO) support throughout the coronavirus 2019 (COVID-19) pandemic, with the hypothesis that mortality would improve as we accumulated knowledge and experience. We included 48 patients supported on veno-venous ECMO (VV-ECMO) at a single institution between April 2020 and December 2021. Patients were categorized into three waves based on cannulation date, corresponding to the wild-type (wave 1), alpha (wave 2), and delta (wave 3) variants. One hundred percent of patients in waves 2 and 3 received glucocorticoids, compared with 29% in wave 1 ( p < 0.01), and the majority received remdesivir (84% and 92% in waves 2 and 3, vs . 35% in wave 1; p < 0.01). Duration of pre-ECMO noninvasive ventilation was longer in waves 2 and 3 (mean 8.8 days and 3.9 days, vs . 0.7 days in wave 1; p < 0.01), as was time to cannulation (mean 17.2 and 14.6 days vs . 8.8 days in wave 1; p < 0.01) and ECMO duration (mean 55.7 days and 43.0 days vs . 28.4 days in wave 1; p = 0.02). Mortality in wave 1 was 35%, compared with 63% and 75% in waves 2 and 3 ( p = 0.05). These results suggest an increased prevalence of medically refractory disease and rising mortality in later variants of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / Noninvasive Ventilation / COVID-19 Type of study: Observational study Topics: Variants Limits: Humans Language: English Journal: ASAIO J Journal subject: Transplantation Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / Noninvasive Ventilation / COVID-19 Type of study: Observational study Topics: Variants Limits: Humans Language: English Journal: ASAIO J Journal subject: Transplantation Year: 2023 Document Type: Article