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COVID-19 outcomes of venovenous extracorporeal membrane oxygenation for acute respiratory failure vs historical cohort of non-COVID-19 viral infections

Title: COVID-19 outcomes of venovenous extracorporeal membrane oxygenation for acute respiratory failure vs historical cohort of non-COVID-19 viral infections
Authors: Dave, Sagar B; Rabinowitz, Ronald; Shah, Aakash; Tabatabai, Ali; Galvagno, Samuel M; Mazzeffi, Michael A; Rector, Raymond; Kaczorowski, David J; Scalea, Thomas M; Menaker, Jay
Source: Perfusion ; volume 38, issue 6, page 1165-1173 ; ISSN 0267-6591 1477-111X
Publisher Information: SAGE Publications
Publication Year: 2022
Description: Introduction Veno-venous extracorporeal membrane oxygenation (VV ECMO) has become a support modality for patients with acute respiratory failure refractory to standard therapies. VV ECMO has been increasingly used during the current COVID-19 pandemic for patients with refractory respiratory failure. The object of this study was to evaluate the outcomes of VV ECMO in patients with COVID-19 compared to patients with non-COVID-19 viral infections. Methods We retrospectively reviewed all patients supported with VV ECMO between 8/2014 and 8/2020 whose etiology of illness was a viral pulmonary infection. The primary outcome of this study was to evaluate in-hospital mortality. The secondary outcomes included length of ECMO course, ventilator duration, hospital length of stay, incidence of adverse events through ECMO course. Results Eighty-nine patients were included (35 COVID-19 vs 54 non-COVID-19). Forty (74%) of the non-COVID-19 patients had influenza virus. Prior to cannulation, COVID-19 patients had longer ventilator duration (3 vs 1 day, p = .003), higher PaCO 2 (64 vs 53 mmHg, p = .012), and white blood cell count (14 vs 9 ×10 3 /μL, p = .004). Overall in-hospital mortality was 33.7% ( n = 30). COVID-19 patients had a higher mortality (49% vs. 24%, p = .017) when compared to non-COVID-19 patients. COVID-19 survivors had longer median time on ECMO than non-COVID-19 survivors (24.4 vs 16.5 days p = .03) but had a similar hospital length of stay (HLOS) (41 vs 48 Extracorporeal Membrane Oxygenationdays p = .33). Conclusion COVID-19 patients supported with VV ECMO have a higher mortality than non-COVID-19 patients. While COVID-19 survivors had significantly longer VV ECMO runs than non-COVID-19 survivors, HLOS was similar. This data add to a growing body of literature supporting the use of ECMO for potentially reversible causes of respiratory failure.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1177/02676591221105603
Availability: https://doi.org/10.1177/02676591221105603; https://journals.sagepub.com/doi/pdf/10.1177/02676591221105603; https://journals.sagepub.com/doi/full-xml/10.1177/02676591221105603
Rights: https://journals.sagepub.com/page/policies/text-and-data-mining-license
Accession Number: edsbas.B68EF38E
Database: BASE