Xiaobo Yang1, Ming Hu2, Yuan Yu1, Xijing Zhang3,4, Minghao Fang5, Yingtao Lian6, Yong Peng7, Lingling Wu2, Yongran Wu1, Jun Yi8, Lu Zhang9, Bing Wang10, Zhengqin Xu11, Boyi Liu12, Yadong Yang13, Xiaowei Xiang14, Xingguang Qu15, Wenhao Xu16, Hunian Li17, Zubo Shen18, Changming Yang19, Fengsheng Cao9, Jie Liu17, Zhaohui Zhang15, Lianghai Li10, Xiaoyun Liu11, Ruiting Li1, Xiaojing Zou1, Huaqing Shu1, Yaqi Ouyang1, Dan Xu1, Jiqian Xu1, Jiancheng Zhang1, Hong Liu1, Hong Qi1, Xuepeng Fan20, Chaolin Huang21, Zhui Yu6, Shiying Yuan1, Dingyu Zhang21, You Shang1. 1. Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 2. Department of Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China. 3. ICU Center of Xijing Hospital, Airforce Medical University, Xi'an, China. 4. ICU of Huoshenshan Hospital, Wuhan, China. 5. Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 6. Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China. 7. Intensive Care Unit, Xiehe Wuhan Red Cross Hospital, Wuhan, China. 8. Department of Cardiothoracic Surgery, The First People's Hospital of Jingmeng, Jingmeng, China. 9. Department of Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China. 10. Department of Critical Care Medicine, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China. 11. Department of Critical Care Medicine, Xiangyang No.1 People's Hospital, Affiliated Hospital of Hubei University of Medicine, Xiangyang, China. 12. Department of Critical Care Medicine, Taihe Hospitai Affiliated to Hubei University Medicine, Shiyan, China. 13. Department of Critical Care Medicine, Huanggang Central Hospital, Huanggang, China. 14. Department of Critical Care Medicine, Dongfeng Hospital, Affiliated to Hubei University of Medicine, Shiyan, China. 15. Department of Intensive Care Unit, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China. 16. Department of Critical Care Medicine, Xiaogan Central Hospital, Xiaogan, China. 17. Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Shiyan, China. 18. Department of Critical Care Medicine, Ezhou Central Hospital, Ezhou, China. 19. Department of Anesthesiology, The First People's Hospital of Jingmeng, Jingmen, China. 20. Department of Critical Care Medicine, Wuhan No.1 Hospital, Wuhan, China. 21. Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China.
Abstract
Background: The data on long-term outcomes of patients infected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available. Methods: A retrospective study included 73 patients infected by SARS-CoV-2 and treated with ECMO in 21 intensive care units in Hubei, China. Data on demographic information, clinical features, laboratory tests, ECMO durations, complications, and living status were collected. Results: The 73 ECMO-treated patients had a median age of 62 (range 33-78) years and 42 (63.6%) were males. Before ECMO initiation, patients had severe respiratory failure on mechanical ventilation with a median PO2/FiO2 of 71.9 [interquartile range (IQR), 58.6-87.0] mmHg and a median PCO2 of 62 [IQR, 43-84] mmHg on arterial blood analyses. The median duration from symptom onset to invasive mechanical ventilation, and to ECMO initiation was19 [IQR, 15-25] days, and 23 [IQR, 19-31] days. Before and after ECMO initiation, the proportions of patients receiving prone position ventilation were 58.9 and 69.9%, respectively. The median duration of ECMO support was 18.5 [IQR 12-30] days. During the treatments with ECMO, major hemorrhages occurred in 31 (42.5%) patients, and oxygenators were replaced in 21 (28.8%) patients. Since ECMO initiation, the 30-day mortality and 60-day mortality were 63.0 and 80.8%, respectively. Conclusions: In Hubei, China, the ECMO-treated patients infected by SARS-CoV-2 were of a broad age range and with severe hypoxemia. The durations of ECMO support, accompanied with increased complications, were relatively long. The long-term mortality in these patients was considerably high.
Background: The data on long-term outcomes of patientsinfected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available. Methods: A retrospective study included 73 patientsinfected by SARS-CoV-2 and treated with ECMO in 21 intensive care units in Hubei, China. Data on demographic information, clinical features, laboratory tests, ECMO durations, complications, and living status were collected. Results: The 73 ECMO-treated patients had a median age of 62 (range 33-78) years and 42 (63.6%) were males. Before ECMO initiation, patients had severe respiratory failure on mechanical ventilation with a median PO2/FiO2 of 71.9 [interquartile range (IQR), 58.6-87.0] mmHg and a median PCO2 of 62 [IQR, 43-84] mmHg on arterial blood analyses. The median duration from symptom onset to invasive mechanical ventilation, and to ECMO initiation was19 [IQR, 15-25] days, and 23 [IQR, 19-31] days. Before and after ECMO initiation, the proportions of patients receiving prone position ventilation were 58.9 and 69.9%, respectively. The median duration of ECMO support was 18.5 [IQR 12-30] days. During the treatments with ECMO, major hemorrhages occurred in 31 (42.5%) patients, and oxygenators were replaced in 21 (28.8%) patients. Since ECMO initiation, the 30-day mortality and 60-day mortality were 63.0 and 80.8%, respectively. Conclusions: In Hubei, China, the ECMO-treated patientsinfected by SARS-CoV-2 were of a broad age range and with severe hypoxemia. The durations of ECMO support, accompanied with increased complications, were relatively long. The long-term mortality in these patients was considerably high.
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