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BMC Pulm Med . Potential for recovery after extremely prolonged VV-ECMO support in well-selected severe COVID-19 patients: a retrospective cohort s

tetano

Editor, Senior Moderator
BMC Pulm Med


. 2024 Jan 8;24(1):19.
doi: 10.1186/s12890-023-02836-3. Potential for recovery after extremely prolonged VV-ECMO support in well-selected severe COVID-19 patients: a retrospective cohort study

Jean-Marc de Walque[SUP] 1 2 [/SUP], Christophe de Terwangne[SUP] 1 [/SUP], Raphaël Jungers[SUP] 3 [/SUP], Sophie Pierard[SUP] 1 4 [/SUP], Christophe Beauloye[SUP] 1 4 [/SUP], Fatima Laarbaui[SUP] 1 [/SUP], Melanie Dechamps[SUP] #[/SUP][SUP] 1 4 [/SUP], Luc Marie Jacquet[SUP] #[/SUP][SUP] 5 6 [/SUP]



Affiliations
Abstract

Background: VenoVenous ExtraCorporeal Membrane Oxygenation (VV-ECMO) has been widely used as supportive therapy for severe respiratory failure related to Acute Respiratory Distress Syndrome (ARDS) due to coronavirus 2019 (COVID-19). Only a few data describe the maximum time under VV-ECMO during which pulmonary recovery remains possible. The main objective of this study is to describe the outcomes of prolonged VV-ECMO in patients with COVID-19-related ARDS.
Methods: This retrospective study was conducted at a tertiary ECMO center in Brussels, Belgium, between March 2020 and April 2022. All adult patients with ARDS due to COVID-19 who were managed with ECMO therapy for more than 50 days as a bridge to recovery were included.
Results: Fourteen patients met the inclusion criteria. The mean duration of VV-ECMO was 87 ± 29 days. Ten (71%) patients were discharged alive from the hospital. The 90-day survival was 86%, and the one-year survival was 71%. The evolution of the patients was characterized by very impaired pulmonary compliance that started to improve slowly and progressively on day 53 (± 25) after the start of ECMO. Of note, four patients improved substantially after a second course of steroids.
Conclusions: There is potential for recovery in patients with very severe ARDS due to COVID-19 supported by VV-ECMO for up to 151 days.

Keywords: Acute respiratory distress syndrome (ARDS); COVID-19; COVID-19 related ARDS; Extracorporeal membrane oxygenation ( ECMO); Prolonged ECMO.

 
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