| Title: |
Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome Associated with COVID-19: An Emulated Target Trial Analysis |
| Authors: |
Hajage, David; Combes, Alain; Guervilly, Christophe; Lebreton, Guillaume; Mercat, Alain; Pavot, Arthur; Nseir, Saad; Mekontso-Dessap, Armand; Mongardon, Nicolas; Mira, Jean Paul; Ricard, Jean-Damien; Beurton, Alexandra; Tachon, Guillaume; Kontar, Loay; Le Terrier, Christophe; Richard, Jean Christophe; Mégarbane, Bruno; Keogh, Ruth; Belot, Aurélien; Maringe, Camille; Leyrat, Clémence; Schmidt, Matthieu; Asfar, Pierre; Beloncle, François; Demiselle, Julien; Pham, Tài; Monnet, Xavier; Richard, Christian; Demoule, Alexandre; Dres, Martin; Mayaux, Julien; Daubin, Cédric; Descamps, Richard; Joret, Aurélie; Du Cheyron, Damien; Pene, Frédéric; Chiche, Jean-Daniel; Jozwiak, Mathieu; Jaubert, Paul; Voiriot, Guillaume; Fartoukh, Muriel; Teulier, Marion; Blayau, Clarisse; l'Her, Erwen; Aubron, Cécile; Bodenes, Laetitia; Ferriere, Nicolas; Auchabie, Johann; Le Meur, Anthony; Pignal, Sylvain; Mazzoni, Thierry; Quenot, Jean-Pierre; Andreu, Pascal; Roudau, Jean-Baptiste; Labruyère, Marie; Preau, Sebastien; Poissy, Julien; Mathieu, Daniel; Benhamida, Sarah; Paulet, Rémi; Roucaud, Nicolas; Thyrault, Martial; Daviet, Florence; Hraiech, Sami; Parzy, Gabriel; Sylvestre, Aude; Jochmans, Sébastien; Bouilland, Anne-Laure; Monchi, Mehran; Danguy Des Déserts, Marc; Mathais, Quentin; Rager, Gwendoline; Pasquier, Pierre; Reignier, Jean; Seguin, Amélie; Garret, Charlotte; Canet, Emmanuel; Dellamonica, Jean; Saccheri, Clément; Lombardi, Romain; Kouchit, Yanis; Jacquier, Sophie; Mathonnet, Armelle; Nay, Mai-Ahn; Runge, Isabelle; Martino, Frédéric; Flurin, Laure; Rolle, Amélie; Carles, Michel; Coudroy, Rémi; W. Thille, Arnaud; Frat, Jean-Pierre; Rodriguez, Maeva; Beuret, Pascal; Tientcheu, Audrey; Vincent, Arthur; Michelin, Florian; Tamion, Fabienne; Carpentier, Dorothée; Boyer, Déborah; Beduneau, Gaetan; Gissot, Valérie; Ehrmann, Stéphan; Salmon Gandonniere, Charlotte; Elaroussi, Djlali; Delbove, Agathe; Fedun, Yannick; Huntzinger, Julien; Lebas, Eddy; Kisoka, Grâce; Grégoire, Céline; Marchetta, Stella; Lambermont, Bernard; Argaud, Laurent; Baudry, Thomas; Bertrand, Pierre-Jean; Dargent, Auguste; Guitton, Christophe; Chudeau, Nicolas; Landais, Mickaël; Darreau, Cédric; Ferre, Alexis; Gros, Antoine; Lacave, Guillaume; Bruneel, Fabrice; Neuville, Mathilde; Devaquet, Jérôme; Gallot, Richard; Chelha, Riad; Galbois, Arnaud; Jallot, Anne; Chalumeau Lemoine, Ludivine; Kuteifan, Khaldoun; Pointurier, Valentin; Jandeaux, Louise-Marie; Mootien, Joy; Damoisel, Charles; Sztrymf, Benjamin; Chommeloux, Juliette; Edouard Luyt, Charles; Schortgen, Frédérique; Rusel, Leon; Jung, Camille; Gobert, Florent; Vimpere, Damien; Lamhaut, Lionel; Sauneuf, Bertrand; Charrrier, Liliane; Calus, Julien; Desmeules, Isabelle; Painvin, Benoît; Tadie, Jean-Marc; Castelain, Vincent; Michard, Baptiste; Herbrecht, Jean-Etienne; Baldacini, Mathieu; Weiss, Nicolas; Demeret, Sophie; Marois, Clémence; Rohaut, Benjamin; Moury, Pierre-Henri; Savida, Anne-Charlotte; Couadau, Emmanuel; Série, Mathieu; Alexandru, Nica; Bruel, Cédric; Fontaine, Candice; Garrigou, Sonia; Courtiade Mahler, Juliette; Leclerc, Maxime; Ramakers, Michel; Garçon, Pierre; Massou, Nicole; van Vong, Ly; Sen, Juliane; Lucas, Nolwenn; Chemouni, Franck; Stoclin, Annabelle; Avenel, Alexandre; Faure, Henri; Gentilhomme, Angélie; Ricome, Sylvie; Abraham, Paul; Monard, Céline; Textoris, Julien; Rimmele, Thomas; Montini, Florent; Lejour, Gabriel; Lazard, Thierry; Etienney, Isabelle; Kerroumi, Younes; Dupuis, Claire; Bereiziat, Marine; Coupez, Elisabeth; Thouy, François; Hoffmann, Clément; Donat, Nicolas; Chrisment, Anne; Blot, Rose-Marie; Kimmoun, Antoine; Jacquot, Audrey; Mattei, Matthieu; Levy, Bruno; Ravan, Ramin; Dopeux, Loïc; Liteaudon, Jean-Mathias; Roux, Delphine; Rey, Brice; Anghel, Radu; Schenesse, Deborah; Gevrey, Vincent; Castanera, Jermy; Petua, Philippe; Madeux, Benjamin; Hartman, Otto; Piagnerelli, Michael; Joosten, Anne; Noel, Cinderella; Biston, Patrick; Noel, Thibaut; Le Bouar, Gurvan; Boukhanza, Messabi; Demarest, Elsa; Bajolet, Marie-France; Charrier, Nathanaël; Quenet, Audrey; Zylberfajn, Cécile; Dufour, Nicolas; Mégarbane, Buno; Voicu, Sébastian; Deye, Nicolas; Malissin, Isabelle; Legay, François; Debarre, Matthieu; Barbarot, Nicolas; Fillatre, Pierre; Delord, Bertrand; Laterrade, Thomas; Saghi, Tahar; Pujol, Wilfried; Julien Cungi, Pierre; Esnault, Pierre; Cardinale, Mickael; Hong Tuan Ha, Vivien; Fleury, Grégory; Brou, Marie-Ange; Zafimahazo, Daniel; Tran-Van, David; Avargues, Patrick; Carenco, Lisa; Robin, Nicolas; Ouali, Alexandre; Houdou, Lucie; Suh, Noémie; Primmaz, Steve; Pugin, Jérome; Weiss, Emmanuel; Gauss, Tobias; Moyer, Jean-Denis; Paugam Burtz, Catherine; La Combe, Béatrice; Smonig, Rolland; Violleau, Jade; Cailliez, Pauline; Chelly, Jonathan; Marchalot, Antoine; Saladin, Cécile; Bigot, Christelle; Fayolle, Pierre-Marie; Fatséas, Jules; Ibrahim, Amr; Resiere, Dabor; Hage, Rabih; Cholet, Clémentine; Cantier, Marie; Trouiler, Pierre; Montravers, Philippe; Lortat-Jacob, Brice; Tanaka, Sebastien; Tran Dinh, Alexy; Duranteau, Jacques; Harrois, Anatole; Dubreuil, Guillaume; Werner, Marie; Godier, Anne; Hamada, Sophie; Zlotnik, Diane; Nougue, Hélène; Carteaux, Guillaume; Razazi, Keyvan; de Prost, Nicolas; Lamraoui, Meriam; Alessandri, Claire; de Roux, Quentin; de Roquetaillade, Charles; G. Chousterman, Benjamin; Mebazaa, Alexandre; Gayat, Etienne; Garnier, Marc; Pardo, Emmanuel; Satre-Buisson, Lea; Gutton, Christophe; Yvin, Elise; Marcault, Clémence; Azoulay, Elie; Darmon, Michael; Ait Oufella, Hafid; Hariri, Geoffroy; Urbina, Tomas; Mazerand, Sandie; Heming, Nicholas; Santi, Francesca; Moine, Pierre; Annane, Djillali; Bouglé, Adrien; Omar, Edris; Lancelot, Aymeric; Begot, Emmanuelle; Plantefeve, Gaétan; Contou, Damien; Mentec, Hervé; Pajot, Olivier; Faguer, Stanislas; Cointault, Olivier; Lavayssiere, Laurence; Nogier, Marie-Béatrice; Jamme, Matthieu; Pichereau, Claire; Hayon, Jan; Outin, Hervé; Dépret, François; Coutrot, Maxime; Chaussard, Maité; Guillemet, Lucie; Goffin, Pierre; Thouny, Romain; Guntz, Julien; Jadot, Laurent; Persichini, Romain; Jean-Michel, Vanessa; Georges, Hugues; Caulier, Thomas; Pradel, Gaël; Hausermann, Marie-Hélène; Nguyen-Valat, Thi My Hue; Boudinaud, Michel; Vivier, Emmanuel; Rosseli, Sylvène; Bourdin, Gaël; Pommier, Christian; Vinclair, Marc; Poignant, Simon; Mons, Sandrine; Bougouin, Wulfran; Bruna, Franklin; Maestraggi, Quentin; Roth, Christian; Bitker, Laurent; Dhelft, François; Bonnet-Chateau, Justine; Filippelli, Mathilde; Morichau-Beauchant, Tristan; Thierry, Stéphane; Le Roy, Charlotte; Saint Jouan, Mélanie; Goncalves, Bruno; Mazeraud, Aurélien; Daniel, Matthieu; Sharshar, Tarek; Cadoz, Cyril; Gaci, Rostane; Gette, Sébastien; Louis, Guillaune; Sacleux, Sophe-Caroline; Ordan, Marie-Amélie; Cravoisy, Aurélie; Conrad, Marie; Courte, Guilhem; Gibot, Sébastien; Benzidi, Younès; Casella, Claudia; Serpin, Laurent; Setti, Jean-Lou; Besse, Marie-Catherine; Bourreau, Anna; Pillot, Jérôme; Rivera, Caroline; Vinclair, Camille; Robaux, Marie-Aline; Achino, Chloé; Delignette, Marie-Charlotte; Mazard, Tessa; Aubrun, Frédéric; Bouchet, Bruno; Frérou, Aurélien; Muller, Laura; Quentin, Charlotte; Degoul, Samuel; Stihle, Xavier; Sumian, Claude; Bergero, Nicoletta; Lanaspre, Bernard; Quintard, Hervé; Marie Maiziere, Eve; Egreteau, Pierre-Yves; Leloup, Guillaume; Berteau, Florin; Cottrel, Marjolaine; Bouteloup, Marie; Jeannot, Matthieu; Blanc, Quentin; Saison, Julien; Geneau, Isabelle; Grenot, Romaric; Ouchike, Abdel; Hazera, Pascal; Masse, Anne-Lyse; Demiri, Suela; Vezinet, Corinne; Baron, Elodie; Benchetrit, Deborah; Monsel, Antoine; Trebbia, Grégoire; Schaack, Emmanuelle; Lepecq, Raphaël; Bobet, Mathieu; Vinsonneau, Christophe; Dekeyser, Thibault; Delforge, Quentin; Rahmani, Imen; Vivet, Bérengère; Paillot, Jonathan; Hierle, Lucie; Chaignat, Claire; Valette, Sarah; Her, Benoït; Brunet, Jennifier; Page, Mathieu; Boiste, Fabienne; Collin, Anthony; Bavozet, Florent; Garin, Aude; Dlala, Mohamed; Mhamdi, Kais; Beilouny, Bassem; Lavalard, Alexandra; Perez, Severine; Veber, Benoit; Guitard, Pierre-Gildas; Gouin, Philippe; Lamacz, Anna; Plouvier, Fabienne; P Delaborde, Bertrand; Kherchache, Aïssa; Chaalal, Amina; Amouretti, Marc; Freita-Ramos, Santiago; Roux, Damien; Constantin, Jean-Michel; Assefi, Mona; Lecore, Marine; Selves, Agathe; Prevost, Florian; Lamer, Christian; Shi, Ruiying; Knani, Lyes; Pili Floury, Sébastien; Vettoretti, Lucie; Levy, Michael; Marsac, Lucile; Dauger, Stéphane; Guilmin-Crépon, Sophie; Winiszewski, Hadrien; Piton, Gael; Soumagne, Thibaud; Capellier, Gilles; Putegnat, Jean-Baptiste; Bayle, Frédérique; Perrou, Maya; Thao, Ghyslaine; Géri, Guillaume; Charron, Cyril; Repessé, Xavier; Vieillard-Baron, Antoine; Guilbart, Mathieu; Roger, Pierre-Alexandre; Hinard, Sébastien; Macq, Pierre-Yves; Chaulier, Kevin; Goutte, Sylvie; Chillet, Patrick; Pitta, Anaïs; Darjent, Barbara; Bruneau, Amandine; Lasocki, Sigismond; Leger, Maxime; Gergaud, Soizic; Lemarie, Pierre; Terzi, Nicolas; Schwebel, Carole; Dartevel, Anaïs; Galerneau, Louis-Marie; Diehl, Jean-Luc; Hauw-Berlemont, Caroline; Péron, Nicolas; Guérot, Emmanuel; Mohebbi Amoli, Abolfazl; Benhamou, Michel; Deyme, Jean-Pierre; Andremont, Olivier; Lena, Diane; Cady, Julien; Causeret, Arnaud; de la Chapelle, Arnaud; Cracco, Christophe; Rouleau, Stéphane; Schnell, David; Foucault, Camille; Lory, Cécile; Chapelle, Thibault; Bruckert, Vincent; Garcia, Julie; Sahraoui, Abdlazize; Abbosh, Nathalie; Bornstain, Caroline; Pernet, Pierre; Poirson, Florent; Pasem, Ahmed; Karoubi, Philippe; Poupinel, Virginie; Gauthier, Caroline; Bouniol, François; Feuchere, Philippe; Heron, Anne; Carreira, Serge; Emery, Malo; Sophie Le Floch, Anne; Giovannangeli, Luana; Herzog, Nicolas; Giacardi, Christophe; Baudic, Thibaut; Thill, Chloé; Lebbah, Said; Palmyre, Jessica; Tubach, Florence; Bonnet, Nicolas; Ebstein, Nathan; Gaudry, Stéphane; Cohen, Yves; Noublanche, Julie; Lesieur, Olivier; Sément, Arnaud; Roca-Cerezo, Isabel; Pascal, Michel; Sma, Nesrine; Colin, Gwenhaël; Lacherade, Jean-Claude; Bionz, Gauthier; Maquigneau, Natacha; Bouzat, Pierre; Durand, Michel; Hérault, Marie-Christine; Payen, Jean-Francois |
| Contributors: |
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576; Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 UGSF; Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 RID-AGE; Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017; Centre Hospitalier Régional Universitaire CHU Lille CHRU Lille; Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 CIIL |
| Publisher Information: |
American Thoracic Society |
| Publication Year: |
2024 |
| Collection: |
LillOA (Lille Open Archive - Université de Lille) |
| Subject Terms: |
extracorporeal membrane oxygenation; acute respiratory distress syndrome; COVID-19; SARS-CoV-2; emulated target trial |
| Description: |
Rationale: Whether patients with coronavirus disease (COVID-19) may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. Objectives: To estimate the effect of ECMO on 90-day mortality versus IMV only. Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO versus no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 < 80 or PaCO2 ⩾ 60 mm Hg). We controlled for confounding using a multivariable Cox model on the basis of predefined variables. Measurements and Main Results: A total of 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability on Day 7 from the onset of eligibility criteria (87% vs. 83%; risk difference, 4%; 95% confidence interval, 0–9%), which decreased during follow-up (survival on Day 90: 63% vs. 65%; risk difference, −2%; 95% confidence interval, −10 to 5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand and when initiated within the first 4 days of IMV and in patients who are profoundly hypoxemic. Conclusions: In an emulated trial on the basis of a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and regions with ECMO capacities specifically organized to handle high demand. ; 206;3 |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/octet-stream |
| Language: |
English |
| Relation: |
American Journal of Respiratory and Critical Care Medicine; Am J Respir Crit Care Med; http://hdl.handle.net/20.500.12210/107817 |
| Availability: |
https://hdl.handle.net/20.500.12210/107817 |
| Rights: |
Attribution-NonCommercial-NoDerivs 3.0 United States ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.B0EFE784 |
| Database: |
BASE |