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Sci Rep
. 2024 Jun 27;14(1):14835.
doi: 10.1038/s41598-024-64949-x. ECMO is associated with decreased hospital mortality in COVID-19 ARDS
Won-Young Kim # 1 , Sun-Young Jung # 2 , Jeong-Yeon Kim # 2 , Ganghee Chae 3 , Junghyun Kim 4 , Joon-Sung Joh 5 , Tae Yun Park 6 , Ae-Rin Baek 7 , Yangjin Jegal 3 , Chi Ryang Chung 8 , Jinwoo Lee 9 , Young-Jae Cho 10 , Joo Hun Park 11 , Jung Hwa Hwang 12 , Jin Woo Song 13
Affiliations
This study determined whether compared to conventional mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO) is associated with decreased hospital mortality or fibrotic changes in patients with COVID-19 acute respiratory distress syndrome. A cohort of 72 patients treated with ECMO and 390 with conventional MV were analyzed (February 2020-December 2021). A target trial was emulated comparing the treatment strategies of initiating ECMO vs no ECMO within 7 days of MV in patients with a PaO2/FiO2 < 80 or a PaCO2 ≥ 60 mmHg. A total of 222 patients met the eligibility criteria for the emulated trial, among whom 42 initiated ECMO. ECMO was associated with a lower risk of hospital mortality (hazard ratio [HR], 0.56; 95% confidence interval [CI] 0.36-0.96). The risk was lower in patients who were younger (age < 70 years), had less comorbidities (Charlson comorbidity index < 2), underwent prone positioning before ECMO, and had driving pressures ≥ 15 cmH2O at inclusion. Furthermore, ECMO was associated with a lower risk of fibrotic changes (HR, 0.30; 95% CI 0.11-0.70). However, the finding was limited due to relatively small number of patients and differences in observability between the ECMO and conventional MV groups.
. 2024 Jun 27;14(1):14835.
doi: 10.1038/s41598-024-64949-x. ECMO is associated with decreased hospital mortality in COVID-19 ARDS
Won-Young Kim # 1 , Sun-Young Jung # 2 , Jeong-Yeon Kim # 2 , Ganghee Chae 3 , Junghyun Kim 4 , Joon-Sung Joh 5 , Tae Yun Park 6 , Ae-Rin Baek 7 , Yangjin Jegal 3 , Chi Ryang Chung 8 , Jinwoo Lee 9 , Young-Jae Cho 10 , Joo Hun Park 11 , Jung Hwa Hwang 12 , Jin Woo Song 13
Affiliations
- PMID: 38937516
- DOI: 10.1038/s41598-024-64949-x
This study determined whether compared to conventional mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO) is associated with decreased hospital mortality or fibrotic changes in patients with COVID-19 acute respiratory distress syndrome. A cohort of 72 patients treated with ECMO and 390 with conventional MV were analyzed (February 2020-December 2021). A target trial was emulated comparing the treatment strategies of initiating ECMO vs no ECMO within 7 days of MV in patients with a PaO2/FiO2 < 80 or a PaCO2 ≥ 60 mmHg. A total of 222 patients met the eligibility criteria for the emulated trial, among whom 42 initiated ECMO. ECMO was associated with a lower risk of hospital mortality (hazard ratio [HR], 0.56; 95% confidence interval [CI] 0.36-0.96). The risk was lower in patients who were younger (age < 70 years), had less comorbidities (Charlson comorbidity index < 2), underwent prone positioning before ECMO, and had driving pressures ≥ 15 cmH2O at inclusion. Furthermore, ECMO was associated with a lower risk of fibrotic changes (HR, 0.30; 95% CI 0.11-0.70). However, the finding was limited due to relatively small number of patients and differences in observability between the ECMO and conventional MV groups.