Outcome of COVID-19 patients treated with VV-ECMO in Tyrol during the pandemic.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-01 Epub Date: 2023-11-10 DOI:10.1007/s00508-023-02301-5

Andreas Peer, Fabian Perschinka, Georg Lehner, Timo Mayerhöfer, Peter Mair, Juliane Kilo, Robert Breitkopf, Dietmar Fries, Michael Joannidis

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Abstract

Introduction: A small percentage of patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) showed severe respiratory deterioration requiring treatment with extracorporeal membrane oxygenation (ECMO). During the pandemic surges availability of ECMO devices was limited and resources had to be used wisely. The aim of this analysis was to determine the incidence and outcome of venovenous (VV) ECMO patients in Tyrol, when criteria based on the Extracorporeal Life Support Organization (ELSO) guidelines for VV-ECMO initiation were established.

Methods: This is a secondary analysis of the Tyrol-CoV-ICU-Reg, which includes all patients admitted to an intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic in Tyrol. Of the 13 participating departments, VV-ECMO was performed at 4 units at the University Hospital Innsbruck.

Results: Overall, 37 (3.4%) of 1101 patients were treated with VV-ECMO during their ICU stay. The hospital mortality rate was approximately 40% (n = 15). Multiorgan failure due to sepsis was the most common cause of death. No significant difference in survival rates between newly initiated and experienced centers was observed. The median survival time of nonsurvivors was 27 days (interquartile range, IQR: 22-36 days) after initiation of VV-ECMO. Acute kidney injury meeting the Kidney Disease: Improving Global Outcomes (KDIGO) criteria occurred in 48.6%. Renal replacement therapy (RRT) was initiated in 12 (32.4%) patients after a median of 18 days (IQR: 1-26 days) after VV-ECMO start. The median length of ICU and hospital stays were 38 days (IQR: 30-55 days) and 50 days (IQR: 37-83 days), respectively.

Discussion: Despite a rapidly increased demand and the resulting requirement to initiate an additional ECMO center, we could demonstrate that a structured approach with interdisciplinary collaboration resulted in favorable survival rates similar to multinational reports.

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新冠肺炎患者在大流行期间在蒂罗尔接受VV-ECMO治疗的结果。

简介：一小部分感染严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的患者表现出严重的呼吸恶化，需要使用体外膜肺氧合（ECMO）进行治疗。在疫情激增期间，ECMO设备的可用性有限，必须明智地使用资源。当基于体外生命支持组织（ELSO）指南制定VV-ECMO启动标准时，本分析的目的是确定蒂罗尔静脉-静脉（VV）ECMO患者的发生率和结果。方法：这是对Tyrol-CoV-ICU-Reg的二次分析，包括2019年冠状病毒病（新冠肺炎）在Tyrol大流行期间入住重症监护室（ICU）的所有患者。在13个参与科室中，VV-ECMO在因斯布鲁克大学医院的4个病房进行。结果：1101名患者中，有37名（3.4%）在ICU期间接受了VV-ECMO治疗。住院死亡率约为40%（n = 15）。败血症引起的多器官衰竭是最常见的死亡原因。新成立的中心和有经验的中心之间的存活率没有显著差异。VV-ECMO启动后，非幸存者的中位生存时间为27天（四分位间距，IQR:22-36天）。48.6%的患者出现了符合肾脏疾病：改善总体预后（KDIGO）标准的急性肾损伤。12名（32.4%）患者在VV-ECMO开始后的中位18天后（IQR:1-26天）开始了肾脏替代治疗（RRT）。ICU和住院时间的中位数分别为38天（IQR:30-55天）和50天（IQR 37-83天）。讨论：尽管需求迅速增加，因此需要建立一个额外的ECMO中心，但我们可以证明，跨学科合作的结构化方法产生了类似于多国报告的良好生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.