Outcomes of Extracorporeal Membrane Oxygenation in COVID-19-Induced Acute Respiratory Distress Syndrome: An Inverse Probability Weighted Analysis. (2024)

Outcomes of Extracorporeal Membrane Oxygenation in COVID-19-Induced Acute Respiratory Distress Syndrome: An Inverse Probability Weighted Analysis. (1)

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Outcomes of Extracorporeal Membrane Oxygenation in COVID-19-Induced Acute Respiratory Distress Syndrome: An Inverse Probability Weighted Analysis.

Raasveld, Senta Jorinde; Taccone, Fabio Silvio; Broman, Lars Mikael; Hermans, Greet; Meersseman, Philippe; Quintana Diaz, Manuel; Delnoij, Thijs S R; van de Poll, Marcel; Gouvea Bogossian, Elisa; van Baarle, Floor L F; Durak, Koray; Zayat, Rashad; Oude Lansink-Hartgring, Annemieke; Meuwese, Christiaan L; van der Heijden, Joris J; de Troy, Erwin; Dauwe, Dieter; Scholten, Erik; van der Velde, Franciska; Maas, Jacinta J; Dos Reis Miranda, Dinis; Kuijpers, Marijn; van den Brule, Judith; van den Bergh, Walter M; Vlaar, Alexander P J.

Affiliation

  • Raasveld SJ; Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Amsterdam, The Netherlands.
  • Taccone FS; Department of Intensive Care, Université Libre de Bruxelles, Hôpital Erasme Bruxelles, Brussels, Belgium.
  • Broman LM; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
  • Hermans G; ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
  • Meersseman P; Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.
  • Quintana Diaz M; Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
  • Delnoij TSR; Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.
  • van de Poll M; Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
  • Gouvea Bogossian E; Department of Intensive Care, Hospital Universitario La Paz, Madrid, Spain.
  • van Baarle FLF; Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Durak K; Department of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands.
  • Zayat R; Department of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands.
  • Oude Lansink-Hartgring A; Department of Intensive Care, Université Libre de Bruxelles, Hôpital Erasme Bruxelles, Brussels, Belgium.
  • Meuwese CL; Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Amsterdam, The Netherlands.
  • van der Heijden JJ; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • de Troy E; Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.
  • Dauwe D; Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Scholten E; Department of Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • van der Velde F; Intensive Care Centre, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
  • Maas JJ; Department of Intensive Care Medicine, Surgical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
  • Dos Reis Miranda D; Department of Intensive Care Medicine, Surgical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
  • Kuijpers M; Department of Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • van den Brule J; Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, The Netherlands.
  • van den Bergh WM; Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, The Netherlands.
  • Vlaar APJ; Department of Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

Article in En

| MEDLINE| ID: mdl-36248318

  • ABSTRACT

ABSTRACT

Although venovenous extracorporeal membrane oxygenation (VV ECMO) has been used in case of COVID-19 induced acute respiratory distress syndrome (ARDS), outcomes and criteria for its application should be evaluated.

OBJECTIVES:

To describe patient characteristics and outcomes in patients receiving VV ECMO due to COVID-19-induced ARDS and to assess the possible impact of COVID-19 on mortality. DESIGN SETTING AND

PARTICIPANTS:

Multicenter retrospective study in 15 ICUs worldwide. All adult patients (> 18 yr) were included if they received VV ECMO with ARDS as main indication. Two groups were created a COVID-19 cohort from March 2020 to December 2020 and a "control" non-COVID ARDS cohort from January 2018 to July 2019. MAIN OUTCOMES AND

MEASURES:

Collected data consisted of patient demographics, baseline variables, ECMO characteristics, and patient outcomes. The primary outcome was 60-day mortality. Secondary outcomes included patient characteristics, COVID-19-related therapies before and during ECMO and complication rate. To assess the influence of COVID-19 on mortality, inverse probability weighted (IPW) analyses were used to correct for predefined confounding variables.

RESULTS:

A total of 193 patients with COVID-19 received VV ECMO. The main indication for VV ECMO consisted of refractory hypoxemia, either isolated or combined with refractory hypercapnia. Complications with the highest occurrence rate included hemorrhage, an additional infectious event or acute kidney injury. Mortality was 35% and 45% at 28 and 60 days, respectively. Those mortality rates did not differ between the first and second waves of COVID-19 in 2020. Furthermore, 60-day mortality was equal between patients with COVID-19 and non-COVID-19-associated ARDS receiving VV ECMO (hazard ratio 60-d mortality, 1.27; 95% CI, 0.82-1.98; p = 0.30). CONCLUSIONS AND RELEVANCE Mortality for patients with COVID-19 who received VV ECMO was similar to that reported in other COVID-19 cohorts, although no differences were found between the first and second waves regarding mortality. In addition, after IPW, mortality was independent of the etiology of ARDS.

Key words

COVID-19; acute respiratory distress syndrome; extracorporeal membrane oxygenation; mortality; venovenous extracorporeal membrane oxygenation

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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Clinical_trials / Observational_studies / Risk_factors_studies Language: En Journal: Crit Care Explor Year: 2022 Document type: Article Affiliation country: Holanda

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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Clinical_trials / Observational_studies / Risk_factors_studies Language: En Journal: Crit Care Explor Year: 2022 Document type: Article Affiliation country: Holanda

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Outcomes of Extracorporeal Membrane Oxygenation in COVID-19-Induced Acute Respiratory Distress Syndrome: An Inverse Probability Weighted Analysis. (3)

Outcomes of Extracorporeal Membrane Oxygenation in COVID-19-Induced Acute Respiratory Distress Syndrome: An Inverse Probability Weighted Analysis. (2024)
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