tetano
Editor, Senior Moderator
ASAIO J
. 2022 Aug 25.
doi: 10.1097/MAT.0000000000001789. Online ahead of print.
Time from Infiltrate on Chest Radiograph to Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Affects Mortality
Elizabeth K Powell[SUP] 1 2 [/SUP], Eric Krause[SUP] 2 3 [/SUP], Emily Esposito[SUP] 1 2 [/SUP], Allison Lankford[SUP] 2 4 [/SUP], Andrea Levine[SUP] 5 [/SUP], Bree Ann C Young[SUP] 6 7 [/SUP], Daniel J Haase[SUP] 1 2 8 [/SUP], Ali Tabatabai[SUP] 2 5 [/SUP], Bradley S Taylor[SUP] 6 [/SUP], Thomas M Scalea[SUP] 2 8 [/SUP], Samuel M Galvagno Jr[SUP] 2 9 [/SUP]
Affiliations
Abstract
Venovenous extracorporeal membrane oxygenation (VV ECMO) has been used to treat severe coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome; however, patient selection criteria have evolved throughout the pandemic. In this study, we sought to determine the association of patient mortality with time from positive COVID-19 test and infiltrate on chest radiograph (x-ray) to VV ECMO cannulation. We hypothesized that an increasing duration between a positive COVID-19 test or infiltrates on chest x-ray and cannulation would be associated with increased mortality. This is a single-center retrospective chart review of COVID-19 VV ECMO patients from March 1, 2020 to July 28, 2021. Unadjusted and adjusted multivariate analyses were performed to assess for mortality differences. A total of 93 patients were included in our study. Increased time, in days, from infiltrate on chest x-ray to cannulation was associated with increased mortality in both unadjusted (5-9, P = 0.002) and adjusted regression analyses (odds ratio [OR]: 1.49, 95% CI: 1.22-1.81, P < 0.01). Time from positive test to cannulation was not found to be significant between survivors and nonsurvivors (7.5-11, P = 0.06). Time from infiltrate on chest x-ray to cannulation for VV ECMO should be considered when assessing patient candidacy. Further larger cohort and prospective studies are required.
. 2022 Aug 25.
doi: 10.1097/MAT.0000000000001789. Online ahead of print.
Time from Infiltrate on Chest Radiograph to Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Affects Mortality
Elizabeth K Powell[SUP] 1 2 [/SUP], Eric Krause[SUP] 2 3 [/SUP], Emily Esposito[SUP] 1 2 [/SUP], Allison Lankford[SUP] 2 4 [/SUP], Andrea Levine[SUP] 5 [/SUP], Bree Ann C Young[SUP] 6 7 [/SUP], Daniel J Haase[SUP] 1 2 8 [/SUP], Ali Tabatabai[SUP] 2 5 [/SUP], Bradley S Taylor[SUP] 6 [/SUP], Thomas M Scalea[SUP] 2 8 [/SUP], Samuel M Galvagno Jr[SUP] 2 9 [/SUP]
Affiliations
- PMID: 36007188
- DOI: 10.1097/MAT.0000000000001789
Abstract
Venovenous extracorporeal membrane oxygenation (VV ECMO) has been used to treat severe coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome; however, patient selection criteria have evolved throughout the pandemic. In this study, we sought to determine the association of patient mortality with time from positive COVID-19 test and infiltrate on chest radiograph (x-ray) to VV ECMO cannulation. We hypothesized that an increasing duration between a positive COVID-19 test or infiltrates on chest x-ray and cannulation would be associated with increased mortality. This is a single-center retrospective chart review of COVID-19 VV ECMO patients from March 1, 2020 to July 28, 2021. Unadjusted and adjusted multivariate analyses were performed to assess for mortality differences. A total of 93 patients were included in our study. Increased time, in days, from infiltrate on chest x-ray to cannulation was associated with increased mortality in both unadjusted (5-9, P = 0.002) and adjusted regression analyses (odds ratio [OR]: 1.49, 95% CI: 1.22-1.81, P < 0.01). Time from positive test to cannulation was not found to be significant between survivors and nonsurvivors (7.5-11, P = 0.06). Time from infiltrate on chest x-ray to cannulation for VV ECMO should be considered when assessing patient candidacy. Further larger cohort and prospective studies are required.