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Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID-19): A retrospective cohort study.
J Card Surg. 2021 Oct; 36(10):3554-3560.JC

Abstract

PURPOSE

The role of extracorporeal membrane oxygenatio (ECMO) for rescue therapy of respiratory failure in critically ill coronavirus disease 2019 (COVID-19) patients remains controversial. We aimed to evaluate the clinical outcomes of ECMO in the treatment of COVID-19 compared with conventional ventilation support.

METHODS

In this retrospective cohort study, data were collected on extremely critical patients with COVID-19 from January 2020 to March 2020 in intensive care unit of a hospital in charge by national rescue team in Wuhan, China, the epicenter of pandemic. Patients were classified into the ECMO group and the conventional ventilation non-ECMO group. Clinical characteristics, technical characteristics, laboratory results, mortality, and complications of the two groups were analyzed.

RESULTS

88 patients with extremely critical COVID-19 were screened; 34 received ECMO support and 31 received conventional ventilation support. Both groups had comparable characteristics at baseline in terms of age, gender, and comorbidities. Before ECMO or conventional therapy, patients in the two groups had sever acute respiratory distress syndrome with a mean partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2 /FiO2) ratio of 69.6 and 75.4, respectively. At the time of reporting, patients in the ECMO had significantly lower in-hospital mortality compared with the control group (58.8 vs. 93.5%, p = .001).

CONCLUSION

ECMO is shown to decrease the mortality of extremely critical ill COVID-19 patients compared with the conventional treatment. Although complications occurred frequently, ECMO could still be a rescue therapy for the treatment of COVID-19 during the pandemic.

Authors+Show Affiliations

Department of Cardiology, Chinese PLA General Hospital, Beijing, China.Department of Neonatology, Affiliated Children's Hospital; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing Medical University, Chongqing, China.Department of Cardiac Surgery, Beijing Anzhen Hospital, Beijing, China.Sichuan University West China Hospital, Chengdu, Sichuan, China.Xiangya Hospital, Changsha, Hunan, China.Department of Cardiology, Chinese PLA General Hospital, Beijing, China.Department of Neonatology, Affiliated Children's Hospital; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing Medical University, Chongqing, China.Department of Cardiology, Chinese PLA General Hospital, Beijing, China.Department of Cardiology, Chinese PLA General Hospital, Beijing, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34292632

Citation

Li, Shuanglei, et al. "Extracorporeal Membrane Oxygenation (ECMO) for Critically Ill Patients With Coronavirus Disease 2019 (COVID-19): a Retrospective Cohort Study." Journal of Cardiac Surgery, vol. 36, no. 10, 2021, pp. 3554-3560.
Li S, Xiong J, Du Z, et al. Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID-19): A retrospective cohort study. J Card Surg. 2021;36(10):3554-3560.
Li, S., Xiong, J., Du, Z., Lai, W., Ma, X., Feng, Z., Shi, Y., Hong, X., & Chen, Y. (2021). Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID-19): A retrospective cohort study. Journal of Cardiac Surgery, 36(10), 3554-3560. https://doi.org/10.1111/jocs.15833
Li S, et al. Extracorporeal Membrane Oxygenation (ECMO) for Critically Ill Patients With Coronavirus Disease 2019 (COVID-19): a Retrospective Cohort Study. J Card Surg. 2021;36(10):3554-3560. PubMed PMID: 34292632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID-19): A retrospective cohort study. AU - Li,Shuanglei, AU - Xiong,Jing, AU - Du,Zhongtao, AU - Lai,Wei, AU - Ma,Xinhua, AU - Feng,Zhichun, AU - Shi,Yuan, AU - Hong,Xiaoyang, AU - Chen,Yundai, Y1 - 2021/07/22/ PY - 2021/06/29/revised PY - 2021/03/05/received PY - 2021/07/10/accepted PY - 2021/7/23/pubmed PY - 2021/9/14/medline PY - 2021/7/22/entrez KW - COVID-19 KW - ECMO KW - SARS-CoV-2 SP - 3554 EP - 3560 JF - Journal of cardiac surgery JO - J Card Surg VL - 36 IS - 10 N2 - PURPOSE: The role of extracorporeal membrane oxygenatio (ECMO) for rescue therapy of respiratory failure in critically ill coronavirus disease 2019 (COVID-19) patients remains controversial. We aimed to evaluate the clinical outcomes of ECMO in the treatment of COVID-19 compared with conventional ventilation support. METHODS: In this retrospective cohort study, data were collected on extremely critical patients with COVID-19 from January 2020 to March 2020 in intensive care unit of a hospital in charge by national rescue team in Wuhan, China, the epicenter of pandemic. Patients were classified into the ECMO group and the conventional ventilation non-ECMO group. Clinical characteristics, technical characteristics, laboratory results, mortality, and complications of the two groups were analyzed. RESULTS: 88 patients with extremely critical COVID-19 were screened; 34 received ECMO support and 31 received conventional ventilation support. Both groups had comparable characteristics at baseline in terms of age, gender, and comorbidities. Before ECMO or conventional therapy, patients in the two groups had sever acute respiratory distress syndrome with a mean partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2 /FiO2) ratio of 69.6 and 75.4, respectively. At the time of reporting, patients in the ECMO had significantly lower in-hospital mortality compared with the control group (58.8 vs. 93.5%, p = .001). CONCLUSION: ECMO is shown to decrease the mortality of extremely critical ill COVID-19 patients compared with the conventional treatment. Although complications occurred frequently, ECMO could still be a rescue therapy for the treatment of COVID-19 during the pandemic. SN - 1540-8191 UR - https://www.unboundmedicine.com/medline/citation/34292632/Extracorporeal_membrane_oxygenation_(ECMO)_for_critically_ill_patients_with_coronavirus_disease_2019_(COVID-19):_A_retrospective_cohort_study. L2 - https://doi.org/10.1111/jocs.15833 DB - PRIME DP - Unbound Medicine ER -