tetano
Editor, Senior Moderator
J Med Virol
. 2023 Jul;95(7):e28961.
doi: 10.1002/jmv.28961. Extracorporeal membrane oxygenation for COVID-19-associated acute respiratory distress syndrome: A nationwide analysis
Atsuyuki Watanabe[SUP] 1 [/SUP], Aaqib Malik[SUP] 2 [/SUP], Tadao Aikawa[SUP] 3 4 [/SUP], Alexandros Briasoulis[SUP] 5 [/SUP], Toshiki Kuno[SUP] 6 7 [/SUP]
Affiliations
Extracorporeal membrane oxygenation (ECMO) has been used for COVID-19-associated acute respiratory distress syndrome (ARDS). We aimed to elucidate the association between ECMO and mortality in patients with COVID-19-associated ARDS in the nationwide setting. United States National Inpatient Sample was used to identify mechanically ventilated adults for COVID-19 with ARDS. We divided them into three groups according to the use of ECMO (i.e., no-ECMO, venovenous [VV]-ECMO, and venoarterial [VA]-ECMO). The primary outcome was in-hospital mortality, while the secondary outcomes included the length of hospital stay (LOS) and the total costs during hospitalization. We performed a stepwise logistic regression, adjusting for baseline characteristics, comorbidities, and severity. We included 68 795 (mean age [SD]: 63.5 [0.1]), 3280 (mean age [SD]: 48.7 [0.5]), and 340 (mean age [SD]: 43.3 [2.1]) patients who received no-, VV-, and VA-ECMO, respectively. The logistic regression analysis did not show significant associations between the use of VV-/VA-ECMO and mortality (adjusted odds ratio with no-ECMO as reference [95% confidence interval]: 1.03 [0.86-1.24] and 1.18 [0.64-2.15], respectively). While LOS was longest with VV-ECMO, the total costs were highest with VA-ECMO. In conclusion, our study found no association between the use of ECMO and mortality of COVID-19-associated ARDS in the nationwide setting.
Keywords: biostatistics & bioinformatics, infection, pandemics; coronavirus; epidemiology; mechanical circulatory support; pathogenesis, analysis of variance; virus classification, respiratory tract.
. 2023 Jul;95(7):e28961.
doi: 10.1002/jmv.28961. Extracorporeal membrane oxygenation for COVID-19-associated acute respiratory distress syndrome: A nationwide analysis
Atsuyuki Watanabe[SUP] 1 [/SUP], Aaqib Malik[SUP] 2 [/SUP], Tadao Aikawa[SUP] 3 4 [/SUP], Alexandros Briasoulis[SUP] 5 [/SUP], Toshiki Kuno[SUP] 6 7 [/SUP]
Affiliations
- PMID: 37477642
- DOI: 10.1002/jmv.28961
Extracorporeal membrane oxygenation (ECMO) has been used for COVID-19-associated acute respiratory distress syndrome (ARDS). We aimed to elucidate the association between ECMO and mortality in patients with COVID-19-associated ARDS in the nationwide setting. United States National Inpatient Sample was used to identify mechanically ventilated adults for COVID-19 with ARDS. We divided them into three groups according to the use of ECMO (i.e., no-ECMO, venovenous [VV]-ECMO, and venoarterial [VA]-ECMO). The primary outcome was in-hospital mortality, while the secondary outcomes included the length of hospital stay (LOS) and the total costs during hospitalization. We performed a stepwise logistic regression, adjusting for baseline characteristics, comorbidities, and severity. We included 68 795 (mean age [SD]: 63.5 [0.1]), 3280 (mean age [SD]: 48.7 [0.5]), and 340 (mean age [SD]: 43.3 [2.1]) patients who received no-, VV-, and VA-ECMO, respectively. The logistic regression analysis did not show significant associations between the use of VV-/VA-ECMO and mortality (adjusted odds ratio with no-ECMO as reference [95% confidence interval]: 1.03 [0.86-1.24] and 1.18 [0.64-2.15], respectively). While LOS was longest with VV-ECMO, the total costs were highest with VA-ECMO. In conclusion, our study found no association between the use of ECMO and mortality of COVID-19-associated ARDS in the nationwide setting.
Keywords: biostatistics & bioinformatics, infection, pandemics; coronavirus; epidemiology; mechanical circulatory support; pathogenesis, analysis of variance; virus classification, respiratory tract.