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Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: A Multicenter Descriptive Study.
Crit Care Med. 2020 09; 48(9):1289-1295.CC

Abstract

OBJECTIVES

Severe acute respiratory distress syndrome is complicated with coronavirus disease 2019 and extracorporeal membrane oxygenation support may be necessary in severe cases. This study is to summarize the clinical features, extracorporeal membrane oxygenation characteristics, and outcomes of patients with severe acute respiratory syndrome coronavirus 2 pneumonia received extracorporeal membrane oxygenation.

DESIGN

Descriptive study from two hospitals.

SETTING

The ICUs from university hospitals.

PATIENTS

Patients with severe acute respiratory syndrome coronavirus 2 pneumonia received mechanical ventilation, including those underwent extracorporeal membrane oxygenation from Zhongnan Hospital of Wuhan University and Wuhan Pulmonary Hospital from January 8, 2020, to March 31, 2020.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Clinical records, laboratory results, ventilator parameters, and extracorporeal membrane oxygenation-related data were abstracted from the medical records. One-hundred twenty-nine critically ill patients with severe acute respiratory syndrome coronavirus 2 pneumonia were admitted to ICU of the two referral hospitals. Fifty-nine patients received mechanical ventilation and 21 of them received extracorporeal membrane oxygenation support (fourteen from Zhongnan hospital and seven from Wuhan pulmonary hospital). Compared to mechanical ventilation patients without extracorporeal membrane oxygenation support, there was a tendency of decline in mortality but with no significant difference (no-extracorporeal membrane oxygenation group 24/38 [63.2%] vs extracorporeal membrane oxygenation group 12/21 [57.1%]; p = 0.782). For those patients with extracorporeal membrane oxygenation, 12 patients died and nine survived by April 7, 2020. Among extracorporeal membrane oxygenation patients, the PaCO2 prior to extracorporeal membrane oxygenation was lower (54.40 mm Hg [29.20-57.50 mm Hg] vs 63.20 mm Hg [55.40-72.12 mm Hg]; p = 0.006), and pH prior to extracorporeal membrane oxygenation was higher (7.38 [7.28-7.48] vs 7.23 [7.16-7.33]; p = 0.023) in survivors than nonsurvivors.

CONCLUSIONS

Extracorporeal membrane oxygenation might be an effective salvage treatment for patients with severe acute respiratory syndrome coronavirus 2 pneumonia associated with severe acute respiratory distress syndrome. Severe CO2 retention and acidosis prior to extracorporeal membrane oxygenation indicated a poor prognosis.

Authors+Show Affiliations

Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.Department of Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, Hubei, China.Department of Emergency Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China.Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32427613

Citation

Yang, Xiao, et al. "Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: a Multicenter Descriptive Study." Critical Care Medicine, vol. 48, no. 9, 2020, pp. 1289-1295.
Yang X, Cai S, Luo Y, et al. Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: A Multicenter Descriptive Study. Crit Care Med. 2020;48(9):1289-1295.
Yang, X., Cai, S., Luo, Y., Zhu, F., Hu, M., Zhao, Y., Zheng, R., Li, X., Hu, B., & Peng, Z. (2020). Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: A Multicenter Descriptive Study. Critical Care Medicine, 48(9), 1289-1295. https://doi.org/10.1097/CCM.0000000000004447
Yang X, et al. Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: a Multicenter Descriptive Study. Crit Care Med. 2020;48(9):1289-1295. PubMed PMID: 32427613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: A Multicenter Descriptive Study. AU - Yang,Xiao, AU - Cai,Shuhan, AU - Luo,Yun, AU - Zhu,Fangfang, AU - Hu,Ming, AU - Zhao,Yan, AU - Zheng,Ruiqiang, AU - Li,Xuyan, AU - Hu,Bo, AU - Peng,Zhiyong, PY - 2020/5/20/pubmed PY - 2020/9/4/medline PY - 2020/5/20/entrez SP - 1289 EP - 1295 JF - Critical care medicine JO - Crit Care Med VL - 48 IS - 9 N2 - OBJECTIVES: Severe acute respiratory distress syndrome is complicated with coronavirus disease 2019 and extracorporeal membrane oxygenation support may be necessary in severe cases. This study is to summarize the clinical features, extracorporeal membrane oxygenation characteristics, and outcomes of patients with severe acute respiratory syndrome coronavirus 2 pneumonia received extracorporeal membrane oxygenation. DESIGN: Descriptive study from two hospitals. SETTING: The ICUs from university hospitals. PATIENTS: Patients with severe acute respiratory syndrome coronavirus 2 pneumonia received mechanical ventilation, including those underwent extracorporeal membrane oxygenation from Zhongnan Hospital of Wuhan University and Wuhan Pulmonary Hospital from January 8, 2020, to March 31, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Clinical records, laboratory results, ventilator parameters, and extracorporeal membrane oxygenation-related data were abstracted from the medical records. One-hundred twenty-nine critically ill patients with severe acute respiratory syndrome coronavirus 2 pneumonia were admitted to ICU of the two referral hospitals. Fifty-nine patients received mechanical ventilation and 21 of them received extracorporeal membrane oxygenation support (fourteen from Zhongnan hospital and seven from Wuhan pulmonary hospital). Compared to mechanical ventilation patients without extracorporeal membrane oxygenation support, there was a tendency of decline in mortality but with no significant difference (no-extracorporeal membrane oxygenation group 24/38 [63.2%] vs extracorporeal membrane oxygenation group 12/21 [57.1%]; p = 0.782). For those patients with extracorporeal membrane oxygenation, 12 patients died and nine survived by April 7, 2020. Among extracorporeal membrane oxygenation patients, the PaCO2 prior to extracorporeal membrane oxygenation was lower (54.40 mm Hg [29.20-57.50 mm Hg] vs 63.20 mm Hg [55.40-72.12 mm Hg]; p = 0.006), and pH prior to extracorporeal membrane oxygenation was higher (7.38 [7.28-7.48] vs 7.23 [7.16-7.33]; p = 0.023) in survivors than nonsurvivors. CONCLUSIONS: Extracorporeal membrane oxygenation might be an effective salvage treatment for patients with severe acute respiratory syndrome coronavirus 2 pneumonia associated with severe acute respiratory distress syndrome. Severe CO2 retention and acidosis prior to extracorporeal membrane oxygenation indicated a poor prognosis. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/32427613/Extracorporeal_Membrane_Oxygenation_for_Coronavirus_Disease_2019_Induced_Acute_Respiratory_Distress_Syndrome:_A_Multicenter_Descriptive_Study_ L2 - https://dx.doi.org/10.1097/CCM.0000000000004447 DB - PRIME DP - Unbound Medicine ER -