tetano
Editor, Senior Moderator
Heliyon
. 2023 Jun;9(6):e17441.
doi: 10.1016/j.heliyon.2023.e17441. Epub 2023 Jun 17. Outcomes of patients with coronavirus disease versus other lung infections requiring venovenous extracorporeal membrane oxygenation
Boris Kuzmin[SUP] 1 [/SUP], Arevik Movsisyan[SUP] 1 [/SUP], Florian Praetsch[SUP] 2 [/SUP], Thomas Schilling[SUP] 2 [/SUP], Anke Lux[SUP] 3 [/SUP], Mohammad Fadel[SUP] 1 [/SUP], Faranak Azizzadeh[SUP] 1 [/SUP], Julia Crackau[SUP] 1 [/SUP], Olaf Keyser[SUP] 1 [/SUP], George Awad[SUP] 1 [/SUP], Thomas Hachenberg[SUP] 2 [/SUP], Jens Wippermann[SUP] 1 [/SUP], Maximilian Scherner[SUP] 1 [/SUP]
Affiliations
Background: Patients with Coronavirus Disease (COVID-19) often develop severe acute respiratory distress syndrome (ARDS) requiring prolonged mechanical ventilation (MV), and venovenous extracorporeal membrane oxygenation (V-V ECMO).Mortality in COVID-19 patients on V-V ECMO was exceptionally high; therefore, whether survival can be ameliorated should be investigated.
Methods: We collected data from 85 patients with severe ARDS who required ECMO support at the University Hospital Magdeburg from 2014 to 2021. The patients were divided into the COVID-19 group (52 patients) and the non-COVID-19 group (33 patients). Demographic and pre-, intra-, and post-ECMO data were retrospectively recorded. The parameters of mechanical ventilation, laboratory data before using ECMO, and during ECMO were compared.
Results: There was a significant difference between the two groups regarding survival: 38.5% of COVID-19 patients and 63.6% of non-COVID-19 patients survived 60 days (p = 0.024). COVID-19 patients required V-V ECMO after 6.5 days of MV, while non-COVID-19 patients required V-V ECMO after 2.0 days of MV (p = 0.048). The COVID-19 group had a greater proportion of patients with ischemic heart disease (21.2% vs 3%, p = 0.019). The rates of most complications were comparable in both groups, whereas the COVID-19 group showed a significantly higher rate of cerebral bleeding (23.1 vs 6.1%, p = 0.039) and lung bacterial superinfection (53.8% vs 9.1%, p = <0.001).
Conclusion: The higher 60-days mortality among patients with COVID-19 with severe ARDS was attributable to superinfection, a higher risk of intracerebral bleeding, and the pre-existing ischemic heart disease.
Keywords: Acute respiratory failure; Bacterial superinfection; Cerebral bleeding; Extracorporeal membrane oxygenation; Viral pneumonia.
. 2023 Jun;9(6):e17441.
doi: 10.1016/j.heliyon.2023.e17441. Epub 2023 Jun 17. Outcomes of patients with coronavirus disease versus other lung infections requiring venovenous extracorporeal membrane oxygenation
Boris Kuzmin[SUP] 1 [/SUP], Arevik Movsisyan[SUP] 1 [/SUP], Florian Praetsch[SUP] 2 [/SUP], Thomas Schilling[SUP] 2 [/SUP], Anke Lux[SUP] 3 [/SUP], Mohammad Fadel[SUP] 1 [/SUP], Faranak Azizzadeh[SUP] 1 [/SUP], Julia Crackau[SUP] 1 [/SUP], Olaf Keyser[SUP] 1 [/SUP], George Awad[SUP] 1 [/SUP], Thomas Hachenberg[SUP] 2 [/SUP], Jens Wippermann[SUP] 1 [/SUP], Maximilian Scherner[SUP] 1 [/SUP]
Affiliations
- PMID: 37366524
- PMCID: PMC10276501
- DOI: 10.1016/j.heliyon.2023.e17441
Background: Patients with Coronavirus Disease (COVID-19) often develop severe acute respiratory distress syndrome (ARDS) requiring prolonged mechanical ventilation (MV), and venovenous extracorporeal membrane oxygenation (V-V ECMO).Mortality in COVID-19 patients on V-V ECMO was exceptionally high; therefore, whether survival can be ameliorated should be investigated.
Methods: We collected data from 85 patients with severe ARDS who required ECMO support at the University Hospital Magdeburg from 2014 to 2021. The patients were divided into the COVID-19 group (52 patients) and the non-COVID-19 group (33 patients). Demographic and pre-, intra-, and post-ECMO data were retrospectively recorded. The parameters of mechanical ventilation, laboratory data before using ECMO, and during ECMO were compared.
Results: There was a significant difference between the two groups regarding survival: 38.5% of COVID-19 patients and 63.6% of non-COVID-19 patients survived 60 days (p = 0.024). COVID-19 patients required V-V ECMO after 6.5 days of MV, while non-COVID-19 patients required V-V ECMO after 2.0 days of MV (p = 0.048). The COVID-19 group had a greater proportion of patients with ischemic heart disease (21.2% vs 3%, p = 0.019). The rates of most complications were comparable in both groups, whereas the COVID-19 group showed a significantly higher rate of cerebral bleeding (23.1 vs 6.1%, p = 0.039) and lung bacterial superinfection (53.8% vs 9.1%, p = <0.001).
Conclusion: The higher 60-days mortality among patients with COVID-19 with severe ARDS was attributable to superinfection, a higher risk of intracerebral bleeding, and the pre-existing ischemic heart disease.
Keywords: Acute respiratory failure; Bacterial superinfection; Cerebral bleeding; Extracorporeal membrane oxygenation; Viral pneumonia.