ABSTRACT
Background: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been demonstrated to be effective in treating patients with virus-induced acute respiratory distress syndrome (ARDS). However, whether the management of ECMO is different in treating H1N1 influenza and coronavirus disease 2019 (COVID-19)-associated ARDS patients remains unknown. Methods: This is a retrospective cohort study. We included 12 VV-ECMO-supported COVID-19 patients admitted to The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Eighth People's Hospital, and Wuhan Union Hospital West Campus between January 23 and March 31, 2020. We retrospectively included VV-ECMO-supported patients with COVID-19 and H1N1 influenza-associated ARDS. Clinical characteristics, respiratory mechanics including plateau pressure, driving pressure, mechanical power, ventilatory ratio (VR) and lung compliance, and outcomes were compared. Results: Data from 25 patients with COVID-19 (n=12) and H1N1 (n=13) associated ARDS who had received ECMO support were analyzed. COVID-19 patients were older than H1N1 influenza patients (P=0.004). The partial pressure of arterial carbon dioxide (PaCO2) and VR before ECMO initiation were significantly higher in COVID-19 patients than in H1N1 influenza patients (P <0.001 and P=0.004, respectively). COVID-19 patients showed increased plateau and driving pressure compared with H1N1 subjects (P=0.013 and P=0.018, respectively). Patients with COVID-19 remained longer on ECMO support than did H1N1 influenza patients (P=0.015). COVID-19 patients who required ECMO support also had fewer intensive care unit and ventilator-free days than H1N1. Conclusions: Compared with H1N1 influenza patients, COVID-19 patients were older and presented with increased PaCO2 and VR values before ECMO initiation. The differences between ARDS patients with COVID-19 and influenza on VV-ECMO detailed herein could be helpful for obtaining a better understanding of COVID-19 and for better clinical management.
ABSTRACT
The metal-organic-framework (MOF) approach is demonstrated as an effective strategy for the morphology evolution control of MIL-53(Fe) with assistance of microwave irradiation. Owing to the homogeneous nucleation offered by microwave irradiation and confined porosity and skeleton by MOF templates, various porous Fe2O3 nanostructures including spindle, concave octahedron, solid octahedron, yolk-shell octahedron, and nanorod with porosity control are derived by simply adjusting the irradiation time. The formation mechanism for the MOF precursors and their derived iron oxides with morphology control is investigated. The main product of the mesoporous yolk-shell octahedron-in-octahedron Fe2O3 nanostructure is also found to be a promising anode material for lithium-ion batteries due to its excellent Li-storage performance. It can deliver a reversible larger-than-theoretical capacity of 1176 mAh g-1 after 200 cycles at 100 mA g-1 and good high-rate performance (744 mAh g-1 after 500 cycles at 1 A g-1).
