Ninh T Nguyen1, Brittany Sullivan, Fabio Sagebin, Samuel F Hohmann, Alpesh Amin, Jeffry Nahmias. 1. From the Department of Surgery, University of California, Irvine Medical Center, Orange, California From Vizient, Centers for Advanced Analytics and Informatics, Chicago, Illinois From the Department of Medicine, University of California, Irvine Medical Center, Orange, California.
Abstract
OBJECTIVE: This study analyzed the outcomes of COVID-19 patients with ARDS who were managed with extracorporeal membrane oxygenation (ECMO) across 155 US academic centers. SUMMARY BACKGROUND DATA: ECMO has been utilized in COVID-19 patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia. Early case series with the use of ECMO in these patients reported high mortality exceeding 90%. METHODS: Using ICD-10 codes, data of patients with COVID-19 with ARDS, managed with ECMO between April - September 2020 were analyzed using the Vizient clinical database. Outcomes measured included in-hospital mortality, hospital and ICU length of stay (LOS) and direct cost. For comparative purposes, the outcome of a subset of COVID-19 patients aged between 18-64 years and managed with vs. without ECMO were examined. RESULTS: 1,1182 patients with COVID-19 and ARDS received ECMO. In-hospital mortality was 45.9%, mean LOS was 36.8 ± 24.9 days and mean ICU stay was 29.1 ± 17.3 days. In-hospital mortality, according to age group was 25.2% for 1-30 years; 42.2% for 31-50 years; 53.2% for 51-64 years; and 73.7% for ≥65 years. A subset analysis of COVID-19 patients, aged 18-64 years with ARDS requiring mechanical ventilation and managed with (n = 1113) vs without (n = 16,343) ECMO, showed relatively high in-hospital mortality for both groups (44.6% with ECMO vs 37.9% without ECMO). CONCLUSIONS: In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO.
OBJECTIVE: This study analyzed the outcomes of COVID-19patients with ARDS who were managed with extracorporeal membrane oxygenation (ECMO) across 155 US academic centers. SUMMARY BACKGROUND DATA: ECMO has been utilized in COVID-19patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia. Early case series with the use of ECMO in these patients reported high mortality exceeding 90%. METHODS: Using ICD-10 codes, data of patients with COVID-19 with ARDS, managed with ECMO between April - September 2020 were analyzed using the Vizient clinical database. Outcomes measured included in-hospital mortality, hospital and ICU length of stay (LOS) and direct cost. For comparative purposes, the outcome of a subset of COVID-19patients aged between 18-64 years and managed with vs. without ECMO were examined. RESULTS: 1,1182 patients with COVID-19 and ARDS received ECMO. In-hospital mortality was 45.9%, mean LOS was 36.8 ± 24.9 days and mean ICU stay was 29.1 ± 17.3 days. In-hospital mortality, according to age group was 25.2% for 1-30 years; 42.2% for 31-50 years; 53.2% for 51-64 years; and 73.7% for ≥65 years. A subset analysis of COVID-19patients, aged 18-64 years with ARDS requiring mechanical ventilation and managed with (n = 1113) vs without (n = 16,343) ECMO, showed relatively high in-hospital mortality for both groups (44.6% with ECMO vs 37.9% without ECMO). CONCLUSIONS: In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO.
Authors: Manish R Mohanka; John Joerns; Adrian Lawrence; Srinivas Bollineni; Vaidehi Kaza; Sreekanth Cheruku; Matthew Leveno; Catherine Chen; Lance S Terada; Corey D Kershaw; Fernando Torres; Matthias Peltz; Michael A Wait; Amy E Hackmann; Amit Banga Journal: Transplantation Date: 2022-04-01 Impact factor: 5.385
Authors: Sahar Leazer; Jacob Collen; Karl Alcover; Erin Tompkins; Shiva Ambardar; Rhonda J Allard; Brian Foster; Ryan McNutt; Matthew Leon; Zachary Haynes; Makala Bascome; Matthias Williams; Jessica Bunin; Patrick G O'Malley; Lisa K Moores; Kevin K Chung Journal: Mil Med Date: 2022-05-27 Impact factor: 1.563