tetano
Editor, Senior Moderator
Sci Rep
. 2024 Jun 27;14(1):14835.
doi: 10.1038/s41598-024-64949-x. ECMO is associated with decreased hospital mortality in COVID-19 ARDS
Won-Young Kim[SUP] #[/SUP][SUP] 1 [/SUP], Sun-Young Jung[SUP] #[/SUP][SUP] 2 [/SUP], Jeong-Yeon Kim[SUP] #[/SUP][SUP] 2 [/SUP], Ganghee Chae[SUP] 3 [/SUP], Junghyun Kim[SUP] 4 [/SUP], Joon-Sung Joh[SUP] 5 [/SUP], Tae Yun Park[SUP] 6 [/SUP], Ae-Rin Baek[SUP] 7 [/SUP], Yangjin Jegal[SUP] 3 [/SUP], Chi Ryang Chung[SUP] 8 [/SUP], Jinwoo Lee[SUP] 9 [/SUP], Young-Jae Cho[SUP] 10 [/SUP], Joo Hun Park[SUP] 11 [/SUP], Jung Hwa Hwang[SUP] 12 [/SUP], Jin Woo Song[SUP] 13 [/SUP]
Affiliations
This study determined whether compared to conventional mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO) is associated with decreased hospital mortality or fibrotic changes in patients with COVID-19 acute respiratory distress syndrome. A cohort of 72 patients treated with ECMO and 390 with conventional MV were analyzed (February 2020-December 2021). A target trial was emulated comparing the treatment strategies of initiating ECMO vs no ECMO within 7 days of MV in patients with a PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] < 80 or a PaCO[SUB]2[/SUB] ≥ 60 mmHg. A total of 222 patients met the eligibility criteria for the emulated trial, among whom 42 initiated ECMO. ECMO was associated with a lower risk of hospital mortality (hazard ratio
, 0.56; 95% confidence interval [CI] 0.36-0.96). The risk was lower in patients who were younger (age < 70 years), had less comorbidities (Charlson comorbidity index < 2), underwent prone positioning before ECMO, and had driving pressures ≥ 15 cmH[SUB]2[/SUB]O at inclusion. Furthermore, ECMO was associated with a lower risk of fibrotic changes (HR, 0.30; 95% CI 0.11-0.70). However, the finding was limited due to relatively small number of patients and differences in observability between the ECMO and conventional MV groups.
. 2024 Jun 27;14(1):14835.
doi: 10.1038/s41598-024-64949-x. ECMO is associated with decreased hospital mortality in COVID-19 ARDS
Won-Young Kim[SUP] #[/SUP][SUP] 1 [/SUP], Sun-Young Jung[SUP] #[/SUP][SUP] 2 [/SUP], Jeong-Yeon Kim[SUP] #[/SUP][SUP] 2 [/SUP], Ganghee Chae[SUP] 3 [/SUP], Junghyun Kim[SUP] 4 [/SUP], Joon-Sung Joh[SUP] 5 [/SUP], Tae Yun Park[SUP] 6 [/SUP], Ae-Rin Baek[SUP] 7 [/SUP], Yangjin Jegal[SUP] 3 [/SUP], Chi Ryang Chung[SUP] 8 [/SUP], Jinwoo Lee[SUP] 9 [/SUP], Young-Jae Cho[SUP] 10 [/SUP], Joo Hun Park[SUP] 11 [/SUP], Jung Hwa Hwang[SUP] 12 [/SUP], Jin Woo Song[SUP] 13 [/SUP]
Affiliations
- PMID: 38937516
- DOI: 10.1038/s41598-024-64949-x
This study determined whether compared to conventional mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO) is associated with decreased hospital mortality or fibrotic changes in patients with COVID-19 acute respiratory distress syndrome. A cohort of 72 patients treated with ECMO and 390 with conventional MV were analyzed (February 2020-December 2021). A target trial was emulated comparing the treatment strategies of initiating ECMO vs no ECMO within 7 days of MV in patients with a PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] < 80 or a PaCO[SUB]2[/SUB] ≥ 60 mmHg. A total of 222 patients met the eligibility criteria for the emulated trial, among whom 42 initiated ECMO. ECMO was associated with a lower risk of hospital mortality (hazard ratio
, 0.56; 95% confidence interval [CI] 0.36-0.96). The risk was lower in patients who were younger (age < 70 years), had less comorbidities (Charlson comorbidity index < 2), underwent prone positioning before ECMO, and had driving pressures ≥ 15 cmH[SUB]2[/SUB]O at inclusion. Furthermore, ECMO was associated with a lower risk of fibrotic changes (HR, 0.30; 95% CI 0.11-0.70). However, the finding was limited due to relatively small number of patients and differences in observability between the ECMO and conventional MV groups.