Article ; Online: Impact of Noninvasive Respiratory Support in Patients With COVID-19 Requiring V-V ECMO.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
2022 Volume 68, Issue 2, Page(s) 171–177
Abstract: ... unknown. We reviewed data of patients with coronavirus disease 2019 (COVID-19) treated with V-V ECMO ...
Abstract | The impact of the duration of noninvasive respiratory support (RS) including high-flow nasal cannula and noninvasive ventilation before the initiation of extracorporeal membrane oxygenation (ECMO) is unknown. We reviewed data of patients with coronavirus disease 2019 (COVID-19) treated with V-V ECMO at two high-volume tertiary care centers. Survival analysis was used to compare the effect of duration of RS on liberation from ECMO. A total of 78 patients required ECMO and the median duration of RS and invasive mechanical ventilation (IMV) before ECMO was 2 days (interquartile range [IQR]: 0, 6) and 2.5 days (IQR: 1, 5), respectively. The median duration of ECMO support was 24 days (IQR: 11, 73) and 59.0% (N = 46) remained alive at the time of censure. Patients that received RS for ≥3 days were significantly less likely to be liberated from ECMO (HR: 0.46; 95% CI: 0.26-0.83), IMV (HR: 0.42; 95% CI: 0.20-0.89) or be discharged from the hospital (HR: 0.52; 95% CI: 0.27-0.99) compared to patients that received RS for <3 days. There was no difference in hospital mortality between the groups (HR: 1.12; 95% CI: 0.56-2.26). These relationships persisted after adjustment for age, gender, and duration of IMV. Prolonged duration of RS before ECMO may result in lung injury and worse subsequent outcomes. |
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MeSH term(s) | COVID-19 ; Extracorporeal Membrane Oxygenation/adverse effects ; Humans ; Respiration, Artificial ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome |
Language | English |
Publishing date | 2022-01-29 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 759982-1 |
ISSN | 1538-943X ; 0162-1432 ; 1058-2916 |
ISSN (online) | 1538-943X |
ISSN | 0162-1432 ; 1058-2916 |
DOI | 10.1097/MAT.0000000000001626 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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