Xiao Yang1, Shuhan Cai1, Yun Luo1, Fangfang Zhu1, Ming Hu2, Yan Zhao3, Ruiqiang Zheng4, Xuyan Li5, Bo Hu1, Zhiyong Peng1. 1. Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China. 2. Department of Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, Hubei, China. 3. Department of Emergency Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China. 4. Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China. 5. Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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.
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 illpatients 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 patientsdied 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: Stephen Su Yang; Jed Lipes; Sandra Dial; Blair Schwartz; Denny Laporta; Evan Wong; Craig Baldry; Paul Warshawsky; Patricia McMillan; David Hornstein; Michel de Marchie; Dev Jayaraman Journal: CMAJ Open Date: 2020-11-24
Authors: Senta Jorinde Raasveld; Thijs S R Delnoij; Lars M Broman; Annemieke Oude Lansink-Hartgring; Greet Hermans; Erwin De Troy; Fabio S Taccone; Manuel Quintana Diaz; Franciska van der Velde; Dinis Dos Reis Miranda; Erik Scholten; Alexander P J Vlaar Journal: J Intensive Care Med Date: 2021-04-07 Impact factor: 3.510
Authors: Stephan Katzenschlager; Alexandra J Zimmer; Claudius Gottschalk; Jürgen Grafeneder; Stephani Schmitz; Sara Kraker; Marlene Ganslmeier; Amelie Muth; Alexander Seitel; Lena Maier-Hein; Andrea Benedetti; Jan Larmann; Markus A Weigand; Sean McGrath; Claudia M Denkinger Journal: PLoS One Date: 2021-07-29 Impact factor: 3.240
Authors: Stephan Katzenschlager; Alexandra J Zimmer; Claudius Gottschalk; Juergen Grafeneder; Alexander Seitel; Lena Maier-Hein; Andrea Benedetti; Jan Larmann; Markus A Weigand; Sean McGrath; Claudia M Denkinger Journal: medRxiv Date: 2020-11-12