Dreier, Esther and Malfertheiner, Maximilian Valentin and Dienemann, Thomas and Fisser, Christoph and Foltan, Maik and Geismann, Florian and Graf, Bernhard and Lunz, Dirk and Maier, Lars Siegfried and Mueller, Thomas and Offner, Robert and Peterhoff, David and Philipp, Alois and Salzberger, Bernd and Schmidt, Barbara and Sinner, Barbara and Lubnow, Matthias (2021) ECMO in COVID-19-prolonged therapy needed? A retrospective analysis of outcome and prognostic factors. PERFUSION-UK, 36 (6): 0267659121. pp. 582-591. ISSN 0267-6591, 1477-111X
Full text not available from this repository. (Request a copy)Abstract
Background: The role of venovenous extracorporeal membrane oxygenation (VV ECMO) in patients with COVID-19-induced acute respiratory distress syndrome (ARDS) still remains unclear. Our aim was to investigate the clinical course and outcome of those patients and to identify factors associated with the need for prolonged ECMO therapy. Methods: A retrospective single-center study on patients with VV ECMO for COVID-19-associated ARDS was performed. Baseline characteristics, ventilatory and ECMO parameters, and laboratory and virological results were evaluated over time. Six months follow-up was assessed. Results: Eleven of 16 patients (68.8%) survived to 6 months follow-up with four patients requiring short-term (<28 days) and seven requiring prolonged (> 28 days) ECMO support. Lung compliance before ECMO was higher in the prolonged than in the short-term group (28.1 (28.8-32.1) ml/cmH(2)O vs 18.7 (17.7-25.0) ml/cmH(2)O, p = 0.030). Mechanical ventilation before ECMO was longer (19 (16-23) days vs 5 (5-9) days, p = 0.002) and SOFA score was higher (12.0 (10.5-17.0) vs 10.0 (9.0-10.0), p = 0.002) in non-survivors compared to survivors. Low viral load during the first days on ECMO tended to indicate worse outcomes. Seroconversion against SARS-CoV-2 occurred in all patients, but did not affect outcome. Conclusions: VV ECMO support for COVID-19-induced ARDS is justified if initiated early and at an experienced ECMO center. Prolonged ECMO therapy might be required in those patients. Although no relevant predictive factors for the duration of ECMO support were found, the decision to stop therapy should not be made dependent of the length of ECMO treatment.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTRACORPOREAL MEMBRANE-OXYGENATION; ACUTE RESPIRATORY-FAILURE; DISTRESS-SYNDROME; COVID-19; SUPPORT; SURVIVAL; PATIENT; COVID-19; extracorporeal membrane oxygenation; ARDS; ECMO; prolonged; SARS-CoV-2 |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Jul 2022 05:11 |
| Last Modified: | 06 Jul 2022 05:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45610 |
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