| Contributors: |
Lorusso, R.; De Piero, M. E.; Mariani, S.; Di Mauro, M.; Folliguet, T.; Taccone, F. S.; Camporota, L.; Swol, J.; Wiedemann, D.; Belliato, M.; Broman, L. M.; Vuylsteke, A.; Kassif, Y.; Scandroglio, A. M.; Fanelli, V.; Gaudard, P.; Ledot, S.; Barker, J.; Boeken, U.; Maier, S.; Kersten, A.; Meyns, B.; Pozzi, M.; Pedersen, F. M.; Schellongowski, P.; Kirali, K.; Barrett, N.; Riera, J.; Mueller, T.; Belohlavek, J.; Lo Coco, V.; Van Der Horst, I. C. C.; Van Bussel, B. C. T.; Schnabel, R. M.; Delnoij, T.; Bolotin, G.; Lorini, L.; Schmiady, M. O.; Schibilsky, D.; Kowalewski, M.; Pinto, L. F.; Silva, P. E.; Kornilov, I.; Blandino Ortiz, A.; Vercaemst, L.; Finney, S.; Roeleveld, P. P.; Di Nardo, M.; Hennig, F.; Antonini, M. V.; Davidson, M.; Jones, T. J.; Staudinger, T.; Mair, P.; Kilo, J.; Krapf, C.; Erbert, K.; Peer, A.; Bonaros, N.; Kotheletner, F.; Krenner Mag, N.; Shestakova, L.; Hermans, G.; Dauwe, D.; Meersseman, P.; Stockman, B.; Nobile, L.; Lhereux, O.; Nrasseurs, A.; Creuter, J.; De Backer, D.; Giglioli, S.; Michiels, G.; Foulon, P.; Raes, M.; Rodrigus, I.; Allegaert, M.; Jorens, P.; Debeucklare, G.; Piagnerelli, M.; Biston, P.; Peperstraete, H.; Vandewiele, K.; Germay, O.; Vandeweghe, D.; Havrin, S.; Bourgeois, M.; Lagny, M. -G.; Alois, G.; Lavios, N.; Misset, B.; Courcelle, R.; Timmermans, P. J.; Yilmaz, A.; Vantomout, M.; Lehaen, J.; Jassen, A.; Guterman, H.; Strauven, M.; Lormans, P. |
| Description: |
Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation. Methods: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic—from March 1 to Sept 13, 2020—at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing. Findings: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46–60]) were included in the study. Median ECMO duration was 15 days (IQR 8–27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients did not die in hospital, and 547 (95%) of 577 ... |