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1. Intracranial pressure monitoring with and without brain tissue oxygen pressure monitoring for severe traumatic brain injury in France (OXY-TC): an open-label, randomised controlled superiority trial

Author

Fevre, Marie-Cecile, SCHILTE, Clotilde, Vincent, Olivier, Hérault, Marie-Christine, Mistral, Thomas, Trouve-Buisson, Thibaut, Picard, Julien, Falcon, Dominique, Bersinger, Samuel, Mourey, Clément, Adolle, Anaïs, Salah, Samia, Manhes, Pauline, Pollet, Angélina, GRECO, Frédéric, CHALARD, kevin, Andréa, Bailleul, Velly, Lionel, Bruder, Nicolas, Inal, Imane, Magand, Clément, Burnol, Laetitia, Morel, Jérôme, PREGNY, Anaèle, FERRE, Jean-Christophe, Bannier, Elise, Lebouvier, Thomas, Caradec, Sophie, Drevet, Claire-Marie, Nadji, Abdelouaid, Lewandowski, Romain, DAILLER, Frédéric, CARRILLON, Romain, GOBERT, Florent, RITZENTHALER, Thomas, LECLERCQ, Mathilde, Dumont, Nathalie, Charpentier, Claire, Alb, Ionel, De Sa, Natalie, Declerck, Nicolas, Boussemart, Pierre, Bellet, Julie, MEAUDRE-DESGOUTTES, Eric, D'ARANDA, Erwan, ESNAULT, Pierre, CHARRUAU, Camille, BELLIER, Rémy, BENARD, Thierry, Carise, Elsa, SEGUIN, Sabrina, Lefrant, Jean Yves, Daurat, Aurélien, Ambert, Audrey, Lebouc, Marie, Hautefeuille, Serge, Escudier, Etienne, Bing, Fabrice, Cosserant, Bernard, Grobost, Romain, Boissy, Camille, Begard, Marc, Guyot, Adrien, Lagarde, Kevin, Caumon, Elodie, Geeraerts, Thomas, POMMIER, Maxime, NABOULSI, Edouard, BEILVERT, Maxime, PARRY, Elodie, Leone, Marc, Zieleskiewicz, Laurent, Duclos, Gary, Arbelot, Charlotte, Carole, Ichai, Hervé, Quintard, Aminata, Diop, Puybasset, Louis, Torkomian, Gregory, Szczot, Magdalena, Kremer, Stephane, Becker, Guillaume, Hecketsweiler, Stephane, ILIC, Dejan, VETTORETTI, Lucie, Grisotto, Coline, Asmolov, Romain, Ehinger, Vincent, Laquay, Nathalie, Chevallier, Virginie, Mahlal, Zahra, LASOCKI, Sigismond, SCHOLASTIQUE, Anne-Sylvie, GAILLARD, Thomas, GERGAUD, Soizic, BARBIER, Emmanuel, TAHON, Florence, KRAINIK, Alexandre, DOJAT, Michel, TROPRES, Irène, VIGUE, Bernard, LEO, Laura, Piriou, Vincent, Coquerel, Antoine, Cracowski, Jean-Luc, Proust, Francois, Mallaret, Michel, Payen, Jean-François, Launey, Yoann, Chabanne, Russell, Gay, Samuel, Francony, Gilles, Gergele, Laurent, Vega, Emmanuel, Montcriol, Ambroise, Couret, David, Cottenceau, Vincent, Pili-Floury, Sebastien, Gakuba, Clement, Hammad, Emmanuelle, Audibert, Gerard, Pottecher, Julien, Dahyot-Fizelier, Claire, Abdennour, Lamine, Gauss, Tobias, Richard, Marion, Vilotitch, Antoine, Bosson, Jean-Luc, and Bouzat, Pierre

Published
2023
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2. SARS-CoV-2-Induced ARDS Associates with MDSC Expansion, Lymphocyte Dysfunction, and Arginine Shortage

Author

Reizine, Florian, Lesouhaitier, Mathieu, Gregoire, Murielle, Pinceaux, Kieran, Gacouin, Arnaud, Maamar, Adel, Painvin, Benoit, Camus, Christophe, Le Tulzo, Yves, Tattevin, Pierre, Revest, Matthieu, Le Bot, Audrey, Ballerie, Alice, Cador-Rousseau, Berengère, Lederlin, Mathieu, Lebouvier, Thomas, Launey, Yoann, Latour, Maelle, Verdy, Clotilde, Rossille, Delphine, Le Gallou, Simon, Dulong, Joelle, Moreau, Caroline, Bendavid, Claude, Roussel, Mikael, Cogne, Michel, Tarte, Karin, and Tadié, Jean-Marc

Published
2021
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4. Intracranial pressure monitoring with and without brain tissue oxygen pressure monitoring for severe traumatic brain injury in France (OXY-TC): an open-label, randomised controlled superiority trial

Author

Payen, Jean-François, primary, Launey, Yoann, additional, Chabanne, Russell, additional, Gay, Samuel, additional, Francony, Gilles, additional, Gergele, Laurent, additional, Vega, Emmanuel, additional, Montcriol, Ambroise, additional, Couret, David, additional, Cottenceau, Vincent, additional, Pili-Floury, Sebastien, additional, Gakuba, Clement, additional, Hammad, Emmanuelle, additional, Audibert, Gerard, additional, Pottecher, Julien, additional, Dahyot-Fizelier, Claire, additional, Abdennour, Lamine, additional, Gauss, Tobias, additional, Richard, Marion, additional, Vilotitch, Antoine, additional, Bosson, Jean-Luc, additional, Bouzat, Pierre, additional, Fevre, Marie-Cecile, additional, SCHILTE, Clotilde, additional, Vincent, Olivier, additional, Hérault, Marie-Christine, additional, Mistral, Thomas, additional, Trouve-Buisson, Thibaut, additional, Picard, Julien, additional, Falcon, Dominique, additional, Bersinger, Samuel, additional, Mourey, Clément, additional, Adolle, Anaïs, additional, Salah, Samia, additional, Manhes, Pauline, additional, Pollet, Angélina, additional, GRECO, Frédéric, additional, CHALARD, kevin, additional, Andréa, Bailleul, additional, Velly, Lionel, additional, Bruder, Nicolas, additional, Inal, Imane, additional, Magand, Clément, additional, Burnol, Laetitia, additional, Morel, Jérôme, additional, PREGNY, Anaèle, additional, FERRE, Jean-Christophe, additional, Bannier, Elise, additional, Lebouvier, Thomas, additional, Caradec, Sophie, additional, Drevet, Claire-Marie, additional, Nadji, Abdelouaid, additional, Lewandowski, Romain, additional, DAILLER, Frédéric, additional, CARRILLON, Romain, additional, GOBERT, Florent, additional, RITZENTHALER, Thomas, additional, LECLERCQ, Mathilde, additional, Dumont, Nathalie, additional, Charpentier, Claire, additional, Alb, Ionel, additional, De Sa, Natalie, additional, Declerck, Nicolas, additional, Boussemart, Pierre, additional, Bellet, Julie, additional, MEAUDRE-DESGOUTTES, Eric, additional, D'ARANDA, Erwan, additional, ESNAULT, Pierre, additional, CHARRUAU, Camille, additional, BELLIER, Rémy, additional, BENARD, Thierry, additional, Carise, Elsa, additional, SEGUIN, Sabrina, additional, Lefrant, Jean Yves, additional, Daurat, Aurélien, additional, Ambert, Audrey, additional, Lebouc, Marie, additional, Hautefeuille, Serge, additional, Escudier, Etienne, additional, Bing, Fabrice, additional, Cosserant, Bernard, additional, Grobost, Romain, additional, Boissy, Camille, additional, Begard, Marc, additional, Guyot, Adrien, additional, Lagarde, Kevin, additional, Caumon, Elodie, additional, Geeraerts, Thomas, additional, POMMIER, Maxime, additional, NABOULSI, Edouard, additional, BEILVERT, Maxime, additional, PARRY, Elodie, additional, Leone, Marc, additional, Zieleskiewicz, Laurent, additional, Duclos, Gary, additional, Arbelot, Charlotte, additional, Carole, Ichai, additional, Hervé, Quintard, additional, Aminata, Diop, additional, Puybasset, Louis, additional, Torkomian, Gregory, additional, Szczot, Magdalena, additional, Kremer, Stephane, additional, Becker, Guillaume, additional, Hecketsweiler, Stephane, additional, ILIC, Dejan, additional, VETTORETTI, Lucie, additional, Grisotto, Coline, additional, Asmolov, Romain, additional, Ehinger, Vincent, additional, Laquay, Nathalie, additional, Chevallier, Virginie, additional, Mahlal, Zahra, additional, LASOCKI, Sigismond, additional, SCHOLASTIQUE, Anne-Sylvie, additional, GAILLARD, Thomas, additional, GERGAUD, Soizic, additional, BARBIER, Emmanuel, additional, TAHON, Florence, additional, KRAINIK, Alexandre, additional, DOJAT, Michel, additional, TROPRES, Irène, additional, VIGUE, Bernard, additional, LEO, Laura, additional, Piriou, Vincent, additional, Coquerel, Antoine, additional, Cracowski, Jean-Luc, additional, Proust, Francois, additional, and Mallaret, Michel, additional

Published
2023
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5. Bleeding and thrombotic events in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study

Author

Mansour, Alexandre, Flecher, Erwan, Schmidt, Matthieu, Rozec, Bertrand, Gouin-Thibault, Isabelle, Esvan, Maxime, Fougerou, Claire, Levy, Bruno, Porto, Alizée, Ross, James, Para, Marylou, Manganiello, Sabrina, Lebreton, Guillaume, Vincentelli, André, Nesseler, Nicolas, Pierrot, Marc, Chocron, Sidney, Flicoteaux, Guillaume, Mauriat, Philippe, Ouattara, Alexandre, Roze, Hadrien, Huet, Olivier, Fischer, Marc-Olivier, Alessandri, Claire, Bellaïche, Raphel, Constant, Ophélie, de Roux, Quentin, Ly, André, Meffert, Arnaud, Merle, Jean-Claude, Mongardon, Nicolas, Picard, Lucile, Skripkina, Elena, Folliguet, Thierry, Fiore, Antonio, D’ostrevy, Nicolas, Morgan, Marie-Catherine, Guinot, Pierre-Grégoire, Nguyen, Maxime, Gaide-Chevronnay, Lucie, Terzi, Nicolas, Colin, Gwenhaël, Fabre, Olivier, Astaneh, Arash, Issard, Justin, Fadel, Elie, Fabre, Dominique, Girault, Antoine, Guihaire, Julien, Ion, Iolande, Menager, Jean Baptiste, Mitilian, Delphine, Mercier, Olaf, Stephan, François, Thes, Jacques, Jouan, Jerôme, Duburcq, Thibault, Loobuyck, Valentin, Moussa, Mouhammed, Mugnier, Agnes, Rousse, Natacha, Desebbe, Olivier, Fellahi, Jean-Luc, Henaine, Roland, Pozzi, Matteo, Richard, Jean-Christophe, Riad, Zakaria, Guervilly, Christophe, Hraiech, Sami, Papazian, Laurent, Castanier, Matthias, Chanavaz, Charles, Cadoz, Cyril, Gette, Sebastien, Louis, Guillaume, Portocarrero, Erick, Gaudard, Philippe, Brini, Kais, Bischoff, Nicolas, Kimmoun, Antoine, Mattei, Mathieu, Perez, Pierre, Bourdiol, Alexandre, Hourmant, Yannick, Mahé, Pierre-Joachim, Jaquet, Pierre, Lortat-Jacob, Brice, Mordant, Pierre, Nataf, Patrick, Patrier, Juliette, Provenchère, Sophie, Roué, Morgan, Sonneville, Romain, Tran-Dinh, Alexy, Wicky, Paul-Henri, Al Zreibi, Charles, Cholley, Bernard, Guyonvarch, Yannis, Hamada, Sophie, Harrois, Anatole, Matiello, Jordi, Kerforne, Thomas, Lacroix, Corentin, Brechot, Nicolas, Combes, Alain, Chommeloux, Juliette, Constantin, Jean Michel, D’alessandro, Cosimo, Demondion, Pierre, Demoule, Alexandre, Dres, Martin, Fadel, Guillaume, Fartoukh, Muriel, Hekimian, Guillaume, Juvin, Charles, Leprince, Pascal, Levy, David, Luyt, Charles Edouard, Pineton de Chambrun, Marc, Schoell, Thibaut, Fillâtre, Pierre, Massart, Nicolas, Nicolas, Roxane, Jonas, Maud, Vidal, Charles, Allou, Nicolas, Muccio, Salvatore, Di Perna, Dario, Ruggieri, Vito-Giovanni, Mourvillier, Bruno, Anselmi, Amedeo, Bounader, Karl, Launey, Yoann, Lebouvier, Thomas, Parasido, Alessandro, Reizine, Florian, Seguin, Philippe, Besnier, Emmanuel, Carpentier, Dorothée, Clavier, Thomas, Falcoz, Pierre-Emmanuel, Olland, Anne, Villard, Marion, Bounes, Fanny, Labaste, François, Minville, Vincent, Guillon, Antoine, Fedun, Yannick, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Réanimation Médicale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital de la Timone [CHU - APHM] (TIMONE), University of California [Davis] (UC Davis), University of California (UC), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Lille, Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and This work was supported by a grant from the university hospital of Rennes (Appel à projets CFTR2) and by a grant from the French society of thoracic and cardio-vascular surgery (Société française de chirurgie thoracique et cardio-vasculaire, Bourse Marc Laskar).

Subjects
Anticoagulation, [SDV]Life Sciences [q-bio], Bleeding, COVID-19, Thrombosis, ECMO, Critical Care and Intensive Care Medicine
Abstract

International audience; Purpose: To describe bleeding and thrombotic events and their risk factors in patients receiving extracorporeal membrane oxygenation (ECMO) for severe coronavirus disease 2019 (COVID-19) and to evaluate their impact on in-hospital mortality.Methods: The ECMOSARS registry included COVID-19 patients supported by ECMO in France. We analyzed all patients included up to March 31, 2022 without missing data regarding bleeding and thrombotic events. The association of bleeding and thrombotic events with in-hospital mortality and pre-ECMO variables was assessed using multivariable logistic regression models.Results: Among 620 patients supported by ECMO, 29% had only bleeding events, 16% only thrombotic events and 20% both bleeding and thrombosis. Cannulation site (18% of patients), ear nose and throat (12%), pulmonary bleeding (9%) and intracranial hemorrhage (8%) were the most frequent bleeding types. Device-related thrombosis and pulmonary embolism/thrombosis accounted for most of thrombotic events. In-hospital mortality was 55.7%. Bleeding events were associated with in-hospital mortality (adjusted odds ratio (adjOR) = 2.91[1.94-4.4]) but not thrombotic events (adjOR = 1.02[0.68-1.53]). Intracranial hemorrhage was strongly associated with in-hospital mortality (adjOR = 13.5[4.4-41.5]). Ventilation duration before ECMO ≥ 7 days and length of ECMO support were associated with bleeding. Thrombosis-associated factors were fibrinogen ≥ 6 g/L and length of ECMO support.Conclusions: In a nationwide cohort of COVID-19 patients supported by ECMO, bleeding incidence was high and associated with mortality. Intracranial hemorrhage incidence was higher than reported for non-COVID patients and carried the highest risk of death. Thrombotic events were less frequent and not associated with mortality. Length of ECMO support was associated with a higher risk of both bleeding and thrombosis, supporting the development of strategies to minimize ECMO duration.

Published
2022

6. Veno-Arterial Extracorporeal Membrane Oxygenation for Circulatory Failure in COVID-19 Patients: Insights from the ECMOSARS Registry

Author

Anselmi, Amedeo, Mansour, Alexandre, Para, Marylou, Mongardon, Nicolas, Porto, Alizée, Guihaire, Julien, Morgant, Marie-Catherine, Pozzi, Matteo, Cholley, Bernard, Falcoz, Pierre-Emmanuel, Gaudard, Philippe, Lebreton, Guillaume, Labaste, François, Barbanti, Claudio, Fouquet, Olivier, Chocron, Sidney, Mottard, Nicolas, Esvan, Maxime, Fougerou-Leurent, Claire, Flecher, Erwan, Vincentelli, André, Nesseler, Nicolas, Pierrot, Marc, Flicoteaux, Guillaume, Mauriat, Philippe, Ouattara, Alexandre, Roze, Hadrien, Huet, Olivier, Fischer, Marc-Olivier, Alessandri, Claire, Bellaïche, Raphel, Constant, Ophélie, Roux, Quentin, Ly, André, Meffert, Arnaud, Merle, Jean-Claude, Picard, Lucile, Skripkina, Elena, Folliguet, Thierry, Fiore, Antonio, d'Ostrevy, Nicolas, Morgan, Marie-Catherine, Guinot, Pierre-Grégoire, Nguyen, Maxime, Gaide-Chevronnay, Lucie, Terzi, Nicolas, Colin, Gwenhaël, Fabre, Olivier, Astaneh, Arash, Issard, Justin, Fadel, Elie, Fabre, Dominique, Girault, Antoine, Ion, Iolande, Menager, Jean Baptiste, Mitilian, Delphine, Mercier, Olaf, Stephan, François, Thes, Jacques, Jouan, Jerôme, Duburcq, Thibault, Loobuyck, Valentin, Moussa, Mouhammed, Mugnier, Agnes, Rousse, Natacha, Manganiello, Sabrina, Desebbe, Olivier, Fellahi, Jean-Luc, Henaine, Roland, Richard, Jean-Christophe, Riad, Zakaria, Guervilly, Christophe, Hraiech, Sami, Papazian, Laurent, Castanier, Matthias, Chanavaz, Charles, Cadoz, Cyril, Gette, Sebastien, Louis, Guillaume, Portocarrero, Erick, Brini, Kais, Bischoff, Nicolas, Levy, Bruno, Kimmoun, Antoine, Mattei, Mathieu, Perez, Pierre, Bourdiol, Alexandre, Hourmant, Yannick, Mahé, Pierre-Joachim, Rozec, Bertrand, Vourc’h, Mickaël, Aubert, Stéphane, Bazalgette, Florian, Roger, Claire, Jaquet, Pierre, Lortat-Jacob, Brice, Mordant, Pierre, Nataf, Patrick, Patrier, Juliette, Provenchere, Sophie, Roué, Morgan, Sonneville, Romain, Tran-Dinh, Alexy, Wicky, Paul-Henri, Al Zreibi, Charles, Guyonvarch, Yannis, Hamada, Sophie, Bertier, Astrid, Harrois, Anatole, Matiello, Jordi, Kerforne, Thomas, Lacroix, Corentin, Brechot, Nicolas, Combes, Alain, Schmidt, Matthieu, Chommeloux, Juliette, Constantin, Jean Michel, D’alessandro, Cosimo, Demondion, Pierre, Demoule, Alexandre, Dres, Martin, Fadel, Guillaume, Fartoukh, Muriel, Hekimian, Guillaume, Juvin, Charles, Leprince, Pascal, Levy, David, Luyt, Charles Edouard, Pineton de Chambrun, Marc, Schoell, Thibaut, Fillâtre, Pierre, Massart, Nicolas, Nicolas, Roxane, Jonas, Maud, Vidal, Charles, Allou, Nicolas, Muccio, Salvatore, Di Perna, Dario, Ruggieri, Vito-Giovanni, Mourvillier, Bruno, Bounader, Karl, Launey, Yoann, Lebouvier, Thomas, Parasido, Alessandro, Reizine, Florian, Seguin, Philippe, Besnier, Emmanuel, Carpentier, Dorothée, Clavier, Thomas, Olland, Anne, Villard, Marion, Bounes, Fanny, Minville, Vincent, Guillon, Antoine, Fedun, Yannick, Ross, James, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), IMRB - PROTECT/'Pharmacologie et Technologies pour les Maladies Cardiovasculaires' [Créteil] (U955 Inserm - UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay, Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Franco-czech Laboratory for clinical research on obesity, Charles University [Prague] (CU)-Institut National de la Santé et de la Recherche Médicale (INSERM), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Nutrition, Métabolismes et Cancer (NuMeCan), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Heart Failure, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, VA-ECMO, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Outcomes, Covid-19
Abstract

International audience; Objectives: The clinical profile and outcomes of patients with Covid-19 who require veno-arterial or veno-venous-arterial extracorporeal membrane oxygenation (VA-ECMO - VAV-ECMO) are poorly understood. We aimed to describe the characteristics and outcomes of these patients and to identify predictors of both favorable and unfavorable outcomes.Methods: ECMOSARS is a multicenter, prospective, nationwide French registry enrolling patients who require VV/VA-ECMO in the context of Covid-19 infection (652 patients at 41 centers). We focused on 47 patients supported with VA- or VAV-ECMO for refractory cardiogenic shock.Results: Median age was 49. 14% of patients had a prior diagnosis of heart failure. The most common etiologies of cardiogenic shock were acute pulmonary embolism (30%), myocarditis (28%), and acute coronary syndrome (4%). E-CPR (Extracorporeal Cardiopulmonary Resuscitation) occurred in 38%. In-hospital survival was 28% in the whole cohort, and 43% when E-CPR patients were excluded. ECMO cannulation was associated with significant improvements in pH and FiO2 on day one, but non-survivors showed significantly more severe acidosis and higher FiO2 than survivors at this point (p = 0.030 and p = 0.006). Other factors associated with death were greater age (p = 0.02), higher BMI (p = 0.03), E-CPR (p = 0.001), non-myocarditis etiology (p = 0.02), higher serum lactates (p = 0.004), epinephrine (but not noradrenaline) use before initiation of ECMO (p = 0.003), hemorrhagic complications (p = 0.001), greater transfusion requirements (p = 0.001), and more severe SAVE and SAFE scores (p = 0.01 and p = 0.03).Conclusions: We report the largest focused analysis of VA- and VAV-ECMO recipients in Covid-19. Although relatively rare, the need for temporary mechanical circulatory support in these patients is associated with poor prognosis. However, VA-ECMO remains a viable solution to rescue carefully selected patients. We identified factors associated with poor prognosis and suggest that E-CPR is not a reasonable indication for VA-ECMO in this population.

Published
2023

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