Veno-venous extracorporeal membrane oxygenation for severe COVID-19 associated acute respiratory distress syndrome: A retrospective, nationwide, Danish cohort study.

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Acta Anaesthesiologica Scandinavica Pub Date : 2025-01-01 Epub Date: 2024-10-22 DOI:10.1111/aas.14522

Finn Møller Pedersen, Lars Grønlykke, Camilla Tofte Eschen, Janne Adelsten, Søren Aalbæk Madsen, Marc Sørensen, Jakob Gjedsted, Peter Hasse Møller-Sørensen, Jonas Nielsen, Steffen Christensen, Dorthe Viemose Nielsen, Vibeke Lind Jørgensen

{"title":"Veno-venous extracorporeal membrane oxygenation for severe COVID-19 associated acute respiratory distress syndrome: A retrospective, nationwide, Danish cohort study.","authors":"Finn Møller Pedersen, Lars Grønlykke, Camilla Tofte Eschen, Janne Adelsten, Søren Aalbæk Madsen, Marc Sørensen, Jakob Gjedsted, Peter Hasse Møller-Sørensen, Jonas Nielsen, Steffen Christensen, Dorthe Viemose Nielsen, Vibeke Lind Jørgensen","doi":"10.1111/aas.14522","DOIUrl":null,"url":null,"abstract":"Background: Severe acute respiratory syndrome (ARDS) may require veno-venous extracorporeal membrane oxygenation (V-V ECMO). The aim of this study was to provide data on patient selection and outcome in a nationwide cohort study of patients with COVID-19 associated ARDS supported with V-V ECMO.Methods: We identified all patients with COVID-19, who were supported with V-V ECMO in Denmark from March 10, 2020, to December 31, 2021, and retrieved data on patients who were referred to- and accepted for ECMO, demographics, outcome data, and complications. Risk factors for mortality were analysed using multivariate Cox regression analysis.Results: During the study period, 1836 patients were admitted to Danish intensive care units (ICUs). In the same period, there were 197 enquiries for ECMO of whom 118 patients were considered eligible. Overall, 71 patients were cannulated for ECMO; three patients were cannulated for veno-arterial extracorporeal membrane oxygenation (V-A ECMO) due to right sided heart failure and 68 patients were cannulated for V-V ECMO. Two patients accepted for V-V ECMO died during cannulation. The median age was 55 years (IQR 45-60) and 66% were males. The median duration of ECMO support was 13 days (IQR 7-21), mechanical ventilation median 26 days (IQR 14-42), ICU stay median 34 days (IQR 17-46), and length of hospital stay median 41 days (IQR 25-56). Ninety-day mortality was 43%. Age of 60 years or more was associated with an increased risk of mortality. Pre-existing hypertension was associated with a decreased risk of mortality.Conclusion: A nationwide, Danish cohort study of 68 COVID-19 patients supported with V-V ECMO, showed a 90-day survival of 43%, which is in accordance with reports from comparable cohorts. Age of 60 years or more was associated with an increased risk of mortality. Pre-existing hypertension was associated with a decreased risk of mortality.","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"e14522"},"PeriodicalIF":1.9000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Anaesthesiologica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/aas.14522","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/22 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Severe acute respiratory syndrome (ARDS) may require veno-venous extracorporeal membrane oxygenation (V-V ECMO). The aim of this study was to provide data on patient selection and outcome in a nationwide cohort study of patients with COVID-19 associated ARDS supported with V-V ECMO.

Methods: We identified all patients with COVID-19, who were supported with V-V ECMO in Denmark from March 10, 2020, to December 31, 2021, and retrieved data on patients who were referred to- and accepted for ECMO, demographics, outcome data, and complications. Risk factors for mortality were analysed using multivariate Cox regression analysis.

Results: During the study period, 1836 patients were admitted to Danish intensive care units (ICUs). In the same period, there were 197 enquiries for ECMO of whom 118 patients were considered eligible. Overall, 71 patients were cannulated for ECMO; three patients were cannulated for veno-arterial extracorporeal membrane oxygenation (V-A ECMO) due to right sided heart failure and 68 patients were cannulated for V-V ECMO. Two patients accepted for V-V ECMO died during cannulation. The median age was 55 years (IQR 45-60) and 66% were males. The median duration of ECMO support was 13 days (IQR 7-21), mechanical ventilation median 26 days (IQR 14-42), ICU stay median 34 days (IQR 17-46), and length of hospital stay median 41 days (IQR 25-56). Ninety-day mortality was 43%. Age of 60 years or more was associated with an increased risk of mortality. Pre-existing hypertension was associated with a decreased risk of mortality.

Conclusion: A nationwide, Danish cohort study of 68 COVID-19 patients supported with V-V ECMO, showed a 90-day survival of 43%, which is in accordance with reports from comparable cohorts. Age of 60 years or more was associated with an increased risk of mortality. Pre-existing hypertension was associated with a decreased risk of mortality.

查看原文本刊更多论文

静脉体外膜氧合治疗严重 COVID-19 相关急性呼吸窘迫综合征：一项回顾性、全国性、丹麦队列研究。

背景：严重急性呼吸综合征（ARDS）可能需要静脉-静脉体外膜氧合（V-V ECMO）。本研究的目的是在一项全国性队列研究中提供有关患者选择和预后的数据，研究对象是接受 V-V ECMO 支持的 COVID-19 相关 ARDS 患者：我们确定了 2020 年 3 月 10 日至 2021 年 12 月 31 日期间在丹麦接受 V-V ECMO 支持的所有 COVID-19 患者，并检索了转诊和接受 ECMO 患者的数据、人口统计学、结果数据和并发症。采用多变量考克斯回归分析法对死亡率的风险因素进行了分析：研究期间，丹麦重症监护病房（ICU）共收治了 1836 名患者。同期，有 197 人咨询 ECMO 事宜，其中 118 人符合条件。总体而言，71 名患者接受了 ECMO 插管；3 名患者因右侧心衰接受了静脉-动脉体外膜氧合（V-A ECMO）插管，68 名患者接受了 V-V ECMO 插管。两名接受 V-V ECMO 的患者在插管期间死亡。中位年龄为 55 岁（IQR 45-60），66% 为男性。ECMO 支持时间中位数为 13 天（IQR 7-21），机械通气时间中位数为 26 天（IQR 14-42），重症监护室住院时间中位数为 34 天（IQR 17-46），住院时间中位数为 41 天（IQR 25-56）。九十天死亡率为 43%。年龄在60岁或以上与死亡风险增加有关。原有高血压与死亡风险降低有关：一项对 68 名接受 V-V ECMO 支持的 COVID-19 患者进行的全国性丹麦队列研究显示，90 天存活率为 43%，这与同类队列的报告一致。年龄在 60 岁或以上与死亡风险增加有关。原有高血压与死亡风险降低有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acta Anaesthesiologica Scandinavica 医学-麻醉学

CiteScore

4.30

自引率

9.50%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.