Extracorporeal Membrane Oxygenation for COVID 2019-Acute Respiratory Distress Syndrome: Comparison between First and Second Waves (Stage 2)

Dognon, Nicolas; Gaudet, Alexandre; Parmentier-Decrucq, Erika; Normandin, Sylvain; Vincentelli, André; Moussa, Mouhamed Djahoum; Poissy, Julien; Duburcq, Thibault; Covid-Group, Lille Intensive Care

doi:10.3390/jcm10214839

Cited by 11 publications

(18 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, the mean duration of ECMO support in patients with ARDS was 1.6 days (SD 2.8), which was relatively short compared to that observed in previous reports 15 , 16 . The difference might be due to the characteristics of patients who underwent ECMO support.…”

Section: Discussioncontrasting

confidence: 59%

Trend of extracorporeal membrane oxygenation support in patients with acute respiratory distress syndrome in South Korea

Song

2022

Sci Rep

View full text Add to dashboard Cite

We examined and compared the clinical characteristics of acute respiratory distress syndrome (ARDS) patients who received and did not receive extracorporeal membrane oxygenation (ECMO) support. The national health insurance database of South Korea was used to obtain real-world data. All adult patients admitted to intensive care units for ARDS treatment between 1 January 2014 and 31 December 2019 were included in this study. Of the 10,173 patients with ARDS included in the analysis, 740 (7.3%) received ECMO support for a mean duration of 1.6 days (standard deviation [SD]: 2.8 days) and were assigned to the ECMO group. The ECMO group had a significantly lower mean age at 57.0 years (SD: 15.7 years) than the non-ECMO group (71.8 Â years [SD: 15.1 Â years], P < 0.001). In multivariable logistic regression, a 1-year increase in age was associated with a 5% lower prevalence of ECMO support. The annual case volume was classified into four groups by quartile ratio (Q1 [lowest], Q2, Q3, and Q4 [highest]), and Q2, Q3, and Q4 groups showed a higher prevalence of ECMO support than the Q1 group. ECMO support was also performed more frequently in high case volume centers than in low case volume centers for ARDS patients.

show abstract

Section: Discussioncontrasting

confidence: 59%

Trend of extracorporeal membrane oxygenation support in patients with acute respiratory distress syndrome in South Korea

Song

2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Data from the EuroECMO survey demonstrated increasing mortality with decreased weaning and survival in the second wave of the pandemic 13 . Similarly, an observational study in France demonstrated longer periods of noninvasive ventilation and worse pulmonary status before ECMO implantation 14 . In Germany, the overall hospital mortality also increased throughout the course of the pandemic 12 .…”

Section: Commentmentioning

confidence: 97%

“… 13 Similarly, an observational study in France demonstrated longer periods of noninvasive ventilation and worse pulmonary status before ECMO implantation. 14 In Germany, the overall hospital mortality also increased throughout the course of the pandemic. 12 A recent report published by the Extracorporeal Life Support Organization Registry (ELSO) found that in‐hospital mortality 90 days after ECMO initiation for COVID‐19 after May 1, 2020 was 52% compared to 37% before that date.…”

Section: Commentmentioning

confidence: 99%

“… 3 The use of extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS) from COVID‐19 who have failed conventional mechanical ventilatory strategies has been described in multiple studies throughout the course of the pandemic. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 Besides limited reports in Europe that have described conflicting trends of patient outcomes on ECMO for COVID‐19 ARDS over the course of the pandemic, 12 , 13 , 14 little is known about the characteristics or trends between the eras of SARS‐CoV‐2 variants at their peak prevalence in the United States. The goal of this study is to describe the outcomes of patients who were placed on ECMO for severe COVID‐19 during different variants phases within a single healthcare system.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Extracorporeal membrane oxygenation for respiratory failure in phases of COVID‐19 variants

Shih

DiMaio

Squiers

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Background Adaptive mutations of the severe acute respiratory syndrome‐related coronavirus (SARS‐CoV‐2) virus have emerged throughout the coronavirus disease 2019 (COVID‐19) pandemic. The characterization of outcomes in patients requiring extracorporeal membrane oxygenation (ECMO) for severe respiratory distress from COVID‐19 during the peak prevalence of different variants is not well known. Methods There were 131 patients with laboratory‐confirmed SARS‐CoV‐2 infection supported by ECMO at two referral centers within a large healthcare system. Three predominant variant phase time windows (Pre‐Alpha, Alpha, and Delta) were determined by a change‐point analyzer based on random population sampling and viral genome sequencing. Patient demographics and outcomes were compared. Results The average age of patients was 46.9 ± 10.5 years and 70.2% (92/131) were male. Patients cannulated for ECMO during the Delta variant wave were younger compared to earlier Pre‐Alpha (39.3 ± 7.8 vs. 48.0 ± 11.1 years) and Alpha phases (39.3 ± 7.8 vs. 47.2 ± 7.7 years) ( p < .01). The predominantly affected race in the Pre‐Alpha phase was Hispanic (52.2%; 47/90), while in Alpha (61.5%; 16/26) and Delta (40%; 6/15) variant waves, most patients were White ( p < .01). Most patients received a tracheostomy (82.4%; 108/131) with a trend toward early intervention in later phases compared to Pre‐Alpha ( p < .01). There was no significant difference between the duration of ECMO, mechanical support, intensive care unit (ICU) length of stay (LOS), or hospital LOS over the three variant phases. The in‐hospital mortality was overall 41.5% (54/131) and was also similar. Six‐month survival of patients who survived to discharge was 92.2% (71/77). Conclusions There was no significant difference in survival or time on ECMO support in patients during the peak prevalence of the three variants.

show abstract

“…There were no differences between the three waves for the occurrence of thrombotic complication, major bleeding, heparin-induced thrombocytopenia, or the use of renal replacement therapy (Table 3). The median duration of ECMO support (24 [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] days vs. 10 [8-21] days, p = 0.001) and ICU stay (36 [24-47] days vs. 26 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], p = 0.008) were higher during the second wave. During their stay in ICU, 100% of the second and the third waves patients developed ventilator-associated pneumonia.…”

Section: Outcomementioning

confidence: 99%

Mortality of COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation During the Three Epidemic Waves

et al. 2022

View full text Add to dashboard Cite

de dominiCis, ‡ VinCent jounieaux, § pasCal Berna, ¶ herVé dupont,* osama aBou-araB,* and yazine mahjouB* Clinical presentation and mortality of patients treated with extracorporeal membrane oxygenation (ECMO) for COVID-19 acute respiratory distress syndrome (CARDS) were different during the French epidemic waves. The management of COVID-19 patients evolved through waves as much as knowledge on that new viral disease progressed. We aimed to compare the mortality rate through the first three waves of CARDS patients on ECMO and identify associated risk factors. Fifty-four consecutive ECMO for CARDS hospitalized at Amiens University Hospital during the three waves were included. Patients were divided into three groups according to their hospitalization date. Clinical characteristics and outcomes were compared between groups. Pre-ECMO risk factors predicting 90 day mortality were evaluated using multivariate Cox regression. Among 54 ECMO (median age of 61[48-65] years), 26% were hospitalized during the first wave (n = 14/54), 26% (n = 14/54) during the second wave, and 48% (n = 26/54) during the third wave. Time from first symptoms to ECMO was higher during the second wave than the first wave. (17 [12-23] days vs. 11 [9-15]; p < 0.05). Ninety day mortality was higher during the second wave (85% vs. 43%; p < 0.05) but less during the third wave (38% vs. 85%; P < 0.05). Respiratory ECMO survival prediction score and time from symptoms onset to ECMO (HR 1.12; 95% confidence interval [CI]: 1.05-1.20; p < 0.001) were independent factors of mortality. After adjustment, time from symptoms onset to ECMO was an independent factor of 90 day mortality. Changes in CARDS management from first to second waveinduced a later ECMO cannulation from symptoms onset with higher mortality during that wave. The duration of COVID-19 disease progression could be selection criteria for initiating ECMO.

show abstract

Extracorporeal Membrane Oxygenation for COVID 2019-Acute Respiratory Distress Syndrome: Comparison between First and Second Waves (Stage 2)

Cited by 11 publications

References 47 publications

Trend of extracorporeal membrane oxygenation support in patients with acute respiratory distress syndrome in South Korea

Trend of extracorporeal membrane oxygenation support in patients with acute respiratory distress syndrome in South Korea

Extracorporeal membrane oxygenation for respiratory failure in phases of COVID‐19 variants

Mortality of COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation During the Three Epidemic Waves

Contact Info

Product

Resources

About