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MeSH Disease



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    Outcomes and risk factors for the survival of COVID-19 MESHD related ARDS MESHD patients treated with extracorporeal membrane oxygenation

    Authors: Luyun Wang; Kengquan Chen; Peng Chen; Li Ni; Jiangang Jiang; Daowen Wang

    doi:10.21203/ Date: 2020-08-13 Source: ResearchSquare

    Background: In current pandemic of COVID-19 MESHD, approximately 15% to 30% of critically ill COVID-19 MESHD patients developed acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) with a high mortality. Extracorporeal membrane of oxygenation (ECMO) provides direct support for both lung and heart in ARDS MESHD. However, the role of ECMO in COVID-19 MESHD related ARDS MESHD was still controversial. The aim of this study was to provide insights into the mortality, intensive care unit (ICU) management, risk factors for mortality, 180-day short term prognosis of the COVID-19 MESHD related severe ARDS MESHD patients receiving ECMO treatment. Methods: From Feb 2nd, 2020 to April 27th, 2020, we included adult TRANS COVID-19 MESHD related ARDS MESHD patients admitted to intensive care unit in Tongji Hospital. Totally, 53 patients were retrospectively analyzed. They were divided into ECMO (mechanical ventilation with ECMO, n=16) and non-ECMO group (mechanical ventilation, n=37). The primary outcome was all-cause 60-day mortality. The secondary outcomes were complications on ECMO, successful weaning from ECMO, and all-cause 180-day mortality. Results: The all-cause 60-day mortality was 37.5% (6/16) in ECMO group and 86.5% (32/37) in non-ECMO group (HR, 0.196; 95% CI, 0.053-0.721; p=0.014). 10 (62.5%) patients were successfully weaned from ECMO. The all-cause 180-day mortality was 56.3% (9/16) in ECMO group and 33 (89.2%, 33/37) in non-ECMO group (HR, 0.298; 95% CI, 0.130-0.680; p=0.004). All the patients in ECMO group suffered from at least one device-related complication with coagulopathy MESHD (81.3%) being most frequently seen. Up to 180-day follow up after disease onset, the ECMO-treated survivors maintained good quality of life without severe complications or disabilities. Hypercapnia MESHD Hypercapnia HP, thrombopenia MESHD, myocardial injury MESHD and elevation of IL-8 and IL-10 during ECMO treatment were strongly associated with death MESHD.Conclusion: This study showed the COVID-19 MESHD patients significantly benefited from ECMO treatment during severe ARDS MESHD, which supported the application of ECMO as an indicated strategy in the management of COVID-19 MESHD related ARDS MESHD.

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MeSH Disease

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