Extra corporeal membrane oxygenation therapy in acute respiratory distress syndrome due to Coronavirus-2019 (COVID-19): a retrospective study

Yıl 2023, Cilt: 6 Sayı: 5, 1059 - 1063, 28.09.2023

Cem Erdoğan Işılay Ayar

https://doi.org/10.32322/jhsm.1347368

Öz

Aims: Extra corporeal membrane oxygenation (ECMO) has been used as a supportive treatment in ARDS due to COVID-19. Although different results have been reported in the literature regarding its efficacy, ECMO is recommended as a salvage therapy for severe forms of the disease after standard therapy fails. In our study,we aimed to evaluate the survival outcomes of patients supported with ECMO for COVID-19.
Methods: Our study was conducted by scanning the data of consecutive adult patients hospitalized in our intensive care unit due to COVID-19. The ECMO process was planned according to the Extracorporeal Life Support Organization (ELSO) and Berlin criteria.
Results: 51 patients hospitalized for acute respiratory failure due to COVID-19 were taken to ECMO. Demographic data of patients; 39 (76.5%) men and 12 (23.5%) women. 46 (90.2%) of the patients died. The mean intubation time before ECMO is 3.9 days, and the mean time for non-invasive mechanical ventilation is 5.8 days. The mean PaO2 value before ECMO was79.09 mmHg, the mean PCO2 value was 63.62 mmHg and the mean PaO2/FiO2 ratio was 82.80.
Conclusion: The use of ECMO by considering prognostic factors and guidelines is seen as factors that increase the chance of success.Despite the fact that the patients were admitted to ECMO in accordance with the guidelines in our study, the high mortality rate suggests that there is a need for investigation of other supportive treatments and studies to reduce ECMO complications.

Anahtar Kelimeler

COVID-19, extracorporeal membrane oxygenations, respiratory distress syndrome, mortality, prognosis

Proje Numarası

YOK

Kaynakça

• World Health Organization: Clinical management of severe acute respirato ry infection when novel coronavirus (nCoV) infection is suspected. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
• Crotti S, Bottino N, Spinelli E: Spontaneous breathing during veno-venous extracorporeal membrane oxygenation. J Thorac Dis. 2018;10(Suppl. 5):S661–669.
• Kurihara C, Walter JM, Singer BD, et al. Extracorporeal membrane oxygenation can successfully support patients with severe acute respiratory distress syndrome in lieu of mechanical ventilation. Crit Care Med. 2018;46(11):e1070-e1073.
• Extracorporeal Life Support Organization (ELSO) report in 2018. Available from: https://www.elso.org/
• Vieira J, Frakes M, Cohen J, Wilcox S. Extracorporeal membrane oxygenation in transport part 2: complications and troubleshooting. Air Med J. 2020;39(2):124–132
• Lim JKB, Qadri SK, Toh TSW, Lin CB, Mok YH, Lee JH. Extracorporeal membrane oxygenation for severe respiratory failure during respiratory epidemics and pandemics: a narrative review. Ann Acad Med Singap. 2020;49(4):199-214.
• Barbaro RP, MacLaren G, Boonstra PS, et al. Extracorporeal Life Support Organization. Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet. 2020;396(10257):1071-1078.
• Combes A, Hajage D, Capellier G, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018;378(21):1965-1975.
• Schmidt M, Hajage D, Lebreton G, et al. Groupe de recherche clinique en reanimation et soins intensifs du patient en insuffisance respiratoire aigue (GRC-RESPIRE) Sorbonne Université; Paris-Sorbonne ECMO-COVID investigators. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome associated with COVID-19: a retrospective cohort study. Lancet Respir Med. 2020;8(11):1121-1131.
• Schmidt M, Pham T, Arcadipane A, et al. Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome. an international multicenter prospective cohort. Am J Respir Crit Care Med. 2019;200(8):1002-1012.
• Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. 2020;58(7):1021-1028.
• Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-847.
• Burrell AJC, Lubnow M, Enger TB, et al. The impact of venovenous extracorporeal membrane oxygenation on cytokine levels in patients with severe acute respiratory distress syndrome: a prospective, observational study. Crit Care Resusc. 2017;19(Suppl 1):37-44.
• Jacobs JP, Stammers AH, St Louis J, et al. Extracorporeal membrane oxygenation in the treatment of severe pulmonary and cardiac compromise in coronavirus disease 2019: experience with 32 patients. ASAIO J. 2020;66(7):722-730.
• Henry BM. COVID-19, ECMO, and lymphopenia: a word of caution. Lancet Respir Med. 2020;8(4):e24.
• Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-848.
• Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-1034.
• Tran A, Fernando SM, Rochwerg B, et al. Prognostic factors associated with mortality among patients receiving venovenous extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Lancet Respir Med. 2022:S2213-2600(22)00296-X.
• Uysal E, Seğmen F, Ulubaşoğlu P, Zengin E.N, Erdem D. The progress of chronic renal disease patients followed by the diagnosis of COVID-19 in ICU. J Health Sci Med. 2022;5(5):1447-1452