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Extracorporeal Membrane Oxygenation for COVID-19 Respiratory Distress Syndrome: An Italian Society for Cardiac Surgery Report.
- Source :
-
ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2021 Apr 01; Vol. 67 (4), pp. 385-391. - Publication Year :
- 2021
-
Abstract
- An increased need of extracorporeal membrane oxygenation (ECMO) support is going to become evident as treatment of SARS-CoV-2 respiratory distress syndrome. This is the first report of the Italian Society for Cardiac Surgery (SICCH) on preliminary experience with COVID-19 patients receiving ECMO support. Data from 12 Italian hospitals participating in SICCH were retrospectively analyzed. Between March 1 and September 15, 2020, a veno-venous (VV) ECMO system was installed in 67 patients (94%) and a veno-arterio-venous ECMO in four (6%). Five patients required VA ECMO after initial weaning from VV ECMO. Thirty (42.2%) patients were weaned from ECMO, while 39 (54.9%) died on ECMO, and six (8.5%) died after ECMO removal. Overall hospital survival was 36.6% (n = 26). Main causes of death were multiple organ failure (n = 14, 31.1%) and sepsis (n = 11, 24.4%). On multivariable analysis, predictors of death while on ECMO support were older age (p = 0.048), elevated pre-ECMO C-reactive protein level (p = 0.048), higher positive end-expiratory pressure on ventilator (p = 0.036) and lower lung compliance (p = 0.032). If the conservative treatment is not effective, ECMO support might be considered as life-saving rescue therapy for COVID-19 refractory respiratory failure. However warm caution and thoughtful approaches for timely detection and treatment should be taken for such a delicate patients population.<br />Competing Interests: Disclosure: The authors have no conflicts of interest to report.<br /> (Copyright © ASAIO 2021.)
- Subjects :
- Acute Kidney Injury etiology
Adult
Aged
Cardiac Surgical Procedures
Female
Humans
Intensive Care Units
Italy epidemiology
Lung Diseases etiology
Male
Middle Aged
Positive-Pressure Respiration
Pulmonary Embolism etiology
Renal Replacement Therapy
Retrospective Studies
Sepsis etiology
Stroke etiology
COVID-19 mortality
COVID-19 therapy
Extracorporeal Membrane Oxygenation adverse effects
Extracorporeal Membrane Oxygenation methods
Respiratory Distress Syndrome therapy
Respiratory Insufficiency etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1538-943X
- Volume :
- 67
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- ASAIO journal (American Society for Artificial Internal Organs : 1992)
- Publication Type :
- Academic Journal
- Accession number :
- 33470643
- Full Text :
- https://doi.org/10.1097/MAT.0000000000001399