Wiest, Clemens and Philipp, Alois and Foltan, Maik and Geismann, Florian and Schneckenpointer, Roland and Baumgartner, Simon and Sticht, Florian and Hitzenbichler, Florian and Arzt, Michael and Fisser, Christoph and Stadlbauer, Andrea and Dienemann, Thomas and Maier, Lars Siegfried and Lunz, Dirk and Mueller, Thomas and Lubnow, Matthias (2024) Refractory circulatory failure in COVID-19 patients treated with veno-arterial ECMO a retrospective single-center experience. PLOS ONE, 19 (4): e0298342. ISSN 1932-6203,
Full text not available from this repository. (Request a copy)Abstract
Objective In this retrospective case series, survival rates in different indications for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and differential diagnoses of COVID-19 associated refractory circulatory failure are investigated.Methods Retrospective analysis of 28 consecutive COVID-19 patients requiring VA-ECMO. All VA-ECMO's were cannulated peripherally, using a femoro-femoral cannulation.Results At VA-ECMO initiation, median age was 57 years (IQR: 51-62), SOFA score 16 (IQR: 13-17) and norepinephrine dosing 0.53 mu g/kg/min (IQR: 0.35-0.87). Virus-variants were: 61% wild-type, 14% Alpha, 18% Delta and 7% Omicron. Indications for VA-ECMO support were pulmonary embolism (PE) (n = 5, survival 80%), right heart failure due to secondary pulmonary hypertension (n = 5, survival 20%), cardiac arrest (n = 4, survival 25%), acute heart failure (AHF) (n = 10, survival 40%) and refractory vasoplegia (n = 4, survival 0%). Among the patients with AHF, 4 patients suffered from COVID-19 associated heart failure (CovHF) (survival 100%) and 6 patients from sepsis associated heart failure (SHF) (survival 0%). Main Complications were acute kidney injury (AKI) 93%, renal replacement therapy was needed in 79%, intracranial hemorrhage occurred in 18%. Overall survival to hospital discharge was 39%.Conclusion Survival on VA-ECMO in COVID-19 depends on VA-ECMO indication, which should be considered in further studies and clinical decision making. A subgroup of patients suffers from acute heart failure due to inflammation, which has to be differentiated into septic or COVID-19 associated. Novel biomarkers are required to ensure reliable differentiation between these entities; a candidate might be soluble interleukin 2 receptor.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTRACORPOREAL MEMBRANE-OXYGENATION; CORONAVIRUS DISEASE 2019; MULTICENTER; OUTCOMES; SEPSIS; |
| Subjects: | 500 Science > 570 Life sciences |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Innere Medizin II Medicine > Institut für Epidemiologie und Präventivmedizin Medicine > Universitäres Herzzentrum Regensburg (UHR) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Jul 2025 11:42 |
| Last Modified: | 15 Jul 2025 11:42 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63378 |
Actions (login required)
 |
View Item |
