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Role of extracorporeal membrane oxygenation in critically Ill COVID‐19 patients and predictors of mortality.

Authors :
Zayat, Rashad
Kalverkamp, Sebastian
Grottke, Oliver
Durak, Koray
Dreher, Michael
Autschbach, Rüdiger
Marx, Gernot
Marx, Nikolaus
Spillner, Jan
Kersten, Alex
Source :
Artificial Organs. Jun2021, Vol. 45 Issue 6, pE158-E170. 13p.
Publication Year :
2021

Abstract

The role of extracorporeal membrane oxygenation (ECMO) in the management of critically ill COVID‐19 patients remains unclear. Our study aims to analyze the outcomes and risk factors from patients treated with ECMO. This retrospective, single‐center study includes 17 COVID‐19 patients treated with ECMO. Univariate and multivariate parametric survival regression identified predictors of survival. Nine patients (53%) were successfully weaned from ECMO and discharged. The incidence of in‐hospital mortality was 47%. In a univariate analysis, only four out of 83 pre‐ECMO variables were significantly different; IL‐6, PCT, and NT‐proBNP were significantly higher in non‐survivors than in survivors. The Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score was significantly higher in survivors. After a multivariate parametric survival regression, IL‐6, NT‐proBNP and RESP scores remained significant independent predictors, with hazard ratios (HR) of 1.069 [95%‐CI: 0.986‐1.160], P =.016 1.001 [95%‐CI: 1.000‐1.001], P =.012; and.843 [95%‐CI: 0.564‐1.260], P =.040, respectively. A prediction model comprising IL‐6, NT‐proBNP, and RESP score showed an area under the curve (AUC) of 0.87, with a sensitivity of 87.5% and 77.8% specificity compared to an AUC of 0.79 for the RESP score alone. The present study suggests that ECMO is a potentially lifesaving treatment for selected critically ill COVID‐19 patients. Considering IL‐6 and NT‐pro‐BNP, in addition to the RESP score, may enhance outcome predictions. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
0160564X
Volume :
45
Issue :
6
Database :
Academic Search Index
Journal :
Artificial Organs
Publication Type :
Academic Journal
Accession number :
150698496
Full Text :
https://doi.org/10.1111/aor.13873