Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19
Purpose Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19). Methods We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU a...
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| Veröffentlicht in: | Intensive care medicine 2021-02, Vol.47 (2), p.208-221 |
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| creator | Shaefi, Shahzad Brenner, Samantha K. Gupta, Shruti O’Gara, Brian P. Krajewski, Megan L. Charytan, David M. Chaudhry, Sobaata Mirza, Sara H. Peev, Vasil Anderson, Mark Bansal, Anip Hayek, Salim S. Srivastava, Anand Mathews, Kusum S. Johns, Tanya S. Leonberg-Yoo, Amanda Green, Adam Arunthamakun, Justin Wille, Keith M. Shaukat, Tanveer Singh, Harkarandeep Admon, Andrew J. Semler, Matthew W. Hernán, Miguel A. Mueller, Ariel L. Wang, Wei Leaf, David E. |
| description | Purpose
Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19).
Methods
We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU admission, using data from a multicenter cohort study of 5122 critically ill adults with COVID-19 admitted to 68 hospitals across the United States. To estimate the effect of ECMO on mortality, we emulated a target trial of ECMO receipt versus no ECMO receipt within 7 days of ICU admission among mechanically ventilated patients with severe hypoxemia (PaO
2
/FiO
2
|
| doi_str_mv | 10.1007/s00134-020-06331-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_proquest_journals_2488774306</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A723910622</galeid><sourcerecordid>A723910622</sourcerecordid><originalsourceid>FETCH-LOGICAL-c579t-60dd8378c72e7dfdaa2df0ed73477611642c40c3b77216bdb6c9c1d0b75b45763</originalsourceid><addsrcrecordid>eNp9kl9rFDEUxYModl39Aj7IgC--pObvZOZFKGvVQqEv6puETHJnmzKTrMlM2_32Zt3aWlkkgYR7f_eQHA5Cryk5poSo95kQygUmjGBSc05x-wQtqOAMU8abp2hBuGBY1IIdoRc5XxVc1ZI-R0ecS9bIVi7Qj9PbKRkb0yYmMEM1wtglE6CKt9s1BDP5GCofqk25QZhydeOnyyrDNSSoEuSNT2aKaVv1xg9zqfUpjtXq4vvZR0zbl-hZb4YMr-7OJfr26fTr6gs-v_h8tjo5x1aqdsI1ca7hqrGKgXK9M4a5noBTXChVU1p-YAWxvFOK0bpzXW1bSx3plOyEVDVfog973c3cjeBseWkyg94kP5q01dF4_bgT_KVex2utGkkbSorAuzuBFH_OkCc9-mxhGIoVcc6aiUZKKnnZS_T2H_QqzimU7-2oRinBSf1Arc0A2oc-7mzeieoTxXhLSc1YofABqvgO5ZExQO9L-RF_fIAvy8Ho7cEBth-wKeacoL_3hBK9C5Heh0iXEOnfIdJtGXrzt5v3I39SUwC-B3JphTWkBwv-I_sLK9fREg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2488774306</pqid></control><display><type>article</type><title>Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19</title><source>MEDLINE</source><source>Springer Online Journals Complete</source><creator>Shaefi, Shahzad ; Brenner, Samantha K. ; Gupta, Shruti ; O’Gara, Brian P. ; Krajewski, Megan L. ; Charytan, David M. ; Chaudhry, Sobaata ; Mirza, Sara H. ; Peev, Vasil ; Anderson, Mark ; Bansal, Anip ; Hayek, Salim S. ; Srivastava, Anand ; Mathews, Kusum S. ; Johns, Tanya S. ; Leonberg-Yoo, Amanda ; Green, Adam ; Arunthamakun, Justin ; Wille, Keith M. ; Shaukat, Tanveer ; Singh, Harkarandeep ; Admon, Andrew J. ; Semler, Matthew W. ; Hernán, Miguel A. ; Mueller, Ariel L. ; Wang, Wei ; Leaf, David E.</creator><creatorcontrib>Shaefi, Shahzad ; Brenner, Samantha K. ; Gupta, Shruti ; O’Gara, Brian P. ; Krajewski, Megan L. ; Charytan, David M. ; Chaudhry, Sobaata ; Mirza, Sara H. ; Peev, Vasil ; Anderson, Mark ; Bansal, Anip ; Hayek, Salim S. ; Srivastava, Anand ; Mathews, Kusum S. ; Johns, Tanya S. ; Leonberg-Yoo, Amanda ; Green, Adam ; Arunthamakun, Justin ; Wille, Keith M. ; Shaukat, Tanveer ; Singh, Harkarandeep ; Admon, Andrew J. ; Semler, Matthew W. ; Hernán, Miguel A. ; Mueller, Ariel L. ; Wang, Wei ; Leaf, David E. ; STOP-COVID Investigators ; the STOP-COVID Investigators</creatorcontrib><description>Purpose
Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19).
Methods
We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU admission, using data from a multicenter cohort study of 5122 critically ill adults with COVID-19 admitted to 68 hospitals across the United States. To estimate the effect of ECMO on mortality, we emulated a target trial of ECMO receipt versus no ECMO receipt within 7 days of ICU admission among mechanically ventilated patients with severe hypoxemia (PaO
2
/FiO
2
< 100). Patients were followed until hospital discharge, death, or a minimum of 60 days. We adjusted for confounding using a multivariable Cox model.
Results
Among the 190 patients treated with ECMO, the median age was 49 years (IQR 41–58), 137 (72.1%) were men, and the median PaO
2
/FiO
2
prior to ECMO initiation was 72 (IQR 61–90). At 60 days, 63 patients (33.2%) had died, 94 (49.5%) were discharged, and 33 (17.4%) remained hospitalized. Among the 1297 patients eligible for the target trial emulation, 45 of the 130 (34.6%) who received ECMO died, and 553 of the 1167 (47.4%) who did not receive ECMO died. In the primary analysis, patients who received ECMO had lower mortality than those who did not (HR 0.55; 95% CI 0.41–0.74). Results were similar in a secondary analysis limited to patients with PaO
2
/FiO
2
< 80 (HR 0.55; 95% CI 0.40–0.77).
Conclusion
In select patients with severe respiratory failure from COVID-19, ECMO may reduce mortality.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-020-06331-9</identifier><identifier>PMID: 33528595</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Analysis ; Anesthesiology ; Care and treatment ; Cohort Studies ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - therapy ; Critical Care Medicine ; Emergency Medicine ; Extracorporeal Membrane Oxygenation ; Failure ; Female ; Health aspects ; Humans ; Hypoxemia ; Intensive ; Intensive care ; Male ; Medicine ; Medicine & Public Health ; Membranes ; Middle Aged ; Mortality ; Original ; Oxygenation ; Pain Medicine ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Respiratory Distress Syndrome - therapy ; Respiratory Distress Syndrome - virology ; Respiratory failure ; Respiratory insufficiency ; Secondary analysis ; Treatment Outcome ; United Kingdom ; Viral diseases</subject><ispartof>Intensive care medicine, 2021-02, Vol.47 (2), p.208-221</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c579t-60dd8378c72e7dfdaa2df0ed73477611642c40c3b77216bdb6c9c1d0b75b45763</citedby><cites>FETCH-LOGICAL-c579t-60dd8378c72e7dfdaa2df0ed73477611642c40c3b77216bdb6c9c1d0b75b45763</cites><orcidid>0000-0002-6832-3282</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-020-06331-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-020-06331-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33528595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaefi, Shahzad</creatorcontrib><creatorcontrib>Brenner, Samantha K.</creatorcontrib><creatorcontrib>Gupta, Shruti</creatorcontrib><creatorcontrib>O’Gara, Brian P.</creatorcontrib><creatorcontrib>Krajewski, Megan L.</creatorcontrib><creatorcontrib>Charytan, David M.</creatorcontrib><creatorcontrib>Chaudhry, Sobaata</creatorcontrib><creatorcontrib>Mirza, Sara H.</creatorcontrib><creatorcontrib>Peev, Vasil</creatorcontrib><creatorcontrib>Anderson, Mark</creatorcontrib><creatorcontrib>Bansal, Anip</creatorcontrib><creatorcontrib>Hayek, Salim S.</creatorcontrib><creatorcontrib>Srivastava, Anand</creatorcontrib><creatorcontrib>Mathews, Kusum S.</creatorcontrib><creatorcontrib>Johns, Tanya S.</creatorcontrib><creatorcontrib>Leonberg-Yoo, Amanda</creatorcontrib><creatorcontrib>Green, Adam</creatorcontrib><creatorcontrib>Arunthamakun, Justin</creatorcontrib><creatorcontrib>Wille, Keith M.</creatorcontrib><creatorcontrib>Shaukat, Tanveer</creatorcontrib><creatorcontrib>Singh, Harkarandeep</creatorcontrib><creatorcontrib>Admon, Andrew J.</creatorcontrib><creatorcontrib>Semler, Matthew W.</creatorcontrib><creatorcontrib>Hernán, Miguel A.</creatorcontrib><creatorcontrib>Mueller, Ariel L.</creatorcontrib><creatorcontrib>Wang, Wei</creatorcontrib><creatorcontrib>Leaf, David E.</creatorcontrib><creatorcontrib>STOP-COVID Investigators</creatorcontrib><creatorcontrib>the STOP-COVID Investigators</creatorcontrib><title>Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose
Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19).
Methods
We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU admission, using data from a multicenter cohort study of 5122 critically ill adults with COVID-19 admitted to 68 hospitals across the United States. To estimate the effect of ECMO on mortality, we emulated a target trial of ECMO receipt versus no ECMO receipt within 7 days of ICU admission among mechanically ventilated patients with severe hypoxemia (PaO
2
/FiO
2
< 100). Patients were followed until hospital discharge, death, or a minimum of 60 days. We adjusted for confounding using a multivariable Cox model.
Results
Among the 190 patients treated with ECMO, the median age was 49 years (IQR 41–58), 137 (72.1%) were men, and the median PaO
2
/FiO
2
prior to ECMO initiation was 72 (IQR 61–90). At 60 days, 63 patients (33.2%) had died, 94 (49.5%) were discharged, and 33 (17.4%) remained hospitalized. Among the 1297 patients eligible for the target trial emulation, 45 of the 130 (34.6%) who received ECMO died, and 553 of the 1167 (47.4%) who did not receive ECMO died. In the primary analysis, patients who received ECMO had lower mortality than those who did not (HR 0.55; 95% CI 0.41–0.74). Results were similar in a secondary analysis limited to patients with PaO
2
/FiO
2
< 80 (HR 0.55; 95% CI 0.40–0.77).
Conclusion
In select patients with severe respiratory failure from COVID-19, ECMO may reduce mortality.</description><subject>Adult</subject><subject>Analysis</subject><subject>Anesthesiology</subject><subject>Care and treatment</subject><subject>Cohort Studies</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - therapy</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Extracorporeal Membrane Oxygenation</subject><subject>Failure</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Hypoxemia</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Membranes</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Original</subject><subject>Oxygenation</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Respiratory Distress Syndrome - therapy</subject><subject>Respiratory Distress Syndrome - virology</subject><subject>Respiratory failure</subject><subject>Respiratory insufficiency</subject><subject>Secondary analysis</subject><subject>Treatment Outcome</subject><subject>United Kingdom</subject><subject>Viral diseases</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kl9rFDEUxYModl39Aj7IgC--pObvZOZFKGvVQqEv6puETHJnmzKTrMlM2_32Zt3aWlkkgYR7f_eQHA5Cryk5poSo95kQygUmjGBSc05x-wQtqOAMU8abp2hBuGBY1IIdoRc5XxVc1ZI-R0ecS9bIVi7Qj9PbKRkb0yYmMEM1wtglE6CKt9s1BDP5GCofqk25QZhydeOnyyrDNSSoEuSNT2aKaVv1xg9zqfUpjtXq4vvZR0zbl-hZb4YMr-7OJfr26fTr6gs-v_h8tjo5x1aqdsI1ca7hqrGKgXK9M4a5noBTXChVU1p-YAWxvFOK0bpzXW1bSx3plOyEVDVfog973c3cjeBseWkyg94kP5q01dF4_bgT_KVex2utGkkbSorAuzuBFH_OkCc9-mxhGIoVcc6aiUZKKnnZS_T2H_QqzimU7-2oRinBSf1Arc0A2oc-7mzeieoTxXhLSc1YofABqvgO5ZExQO9L-RF_fIAvy8Ho7cEBth-wKeacoL_3hBK9C5Heh0iXEOnfIdJtGXrzt5v3I39SUwC-B3JphTWkBwv-I_sLK9fREg</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Shaefi, Shahzad</creator><creator>Brenner, Samantha K.</creator><creator>Gupta, Shruti</creator><creator>O’Gara, Brian P.</creator><creator>Krajewski, Megan L.</creator><creator>Charytan, David M.</creator><creator>Chaudhry, Sobaata</creator><creator>Mirza, Sara H.</creator><creator>Peev, Vasil</creator><creator>Anderson, Mark</creator><creator>Bansal, Anip</creator><creator>Hayek, Salim S.</creator><creator>Srivastava, Anand</creator><creator>Mathews, Kusum S.</creator><creator>Johns, Tanya S.</creator><creator>Leonberg-Yoo, Amanda</creator><creator>Green, Adam</creator><creator>Arunthamakun, Justin</creator><creator>Wille, Keith M.</creator><creator>Shaukat, Tanveer</creator><creator>Singh, Harkarandeep</creator><creator>Admon, Andrew J.</creator><creator>Semler, Matthew W.</creator><creator>Hernán, Miguel A.</creator><creator>Mueller, Ariel L.</creator><creator>Wang, Wei</creator><creator>Leaf, David E.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6832-3282</orcidid></search><sort><creationdate>20210201</creationdate><title>Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19</title><author>Shaefi, Shahzad ; Brenner, Samantha K. ; Gupta, Shruti ; O’Gara, Brian P. ; Krajewski, Megan L. ; Charytan, David M. ; Chaudhry, Sobaata ; Mirza, Sara H. ; Peev, Vasil ; Anderson, Mark ; Bansal, Anip ; Hayek, Salim S. ; Srivastava, Anand ; Mathews, Kusum S. ; Johns, Tanya S. ; Leonberg-Yoo, Amanda ; Green, Adam ; Arunthamakun, Justin ; Wille, Keith M. ; Shaukat, Tanveer ; Singh, Harkarandeep ; Admon, Andrew J. ; Semler, Matthew W. ; Hernán, Miguel A. ; Mueller, Ariel L. ; Wang, Wei ; Leaf, David E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c579t-60dd8378c72e7dfdaa2df0ed73477611642c40c3b77216bdb6c9c1d0b75b45763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Anesthesiology</topic><topic>Care and treatment</topic><topic>Cohort Studies</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - therapy</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Extracorporeal Membrane Oxygenation</topic><topic>Failure</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Hypoxemia</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Membranes</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Original</topic><topic>Oxygenation</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Respiratory Distress Syndrome - therapy</topic><topic>Respiratory Distress Syndrome - virology</topic><topic>Respiratory failure</topic><topic>Respiratory insufficiency</topic><topic>Secondary analysis</topic><topic>Treatment Outcome</topic><topic>United Kingdom</topic><topic>Viral diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaefi, Shahzad</creatorcontrib><creatorcontrib>Brenner, Samantha K.</creatorcontrib><creatorcontrib>Gupta, Shruti</creatorcontrib><creatorcontrib>O’Gara, Brian P.</creatorcontrib><creatorcontrib>Krajewski, Megan L.</creatorcontrib><creatorcontrib>Charytan, David M.</creatorcontrib><creatorcontrib>Chaudhry, Sobaata</creatorcontrib><creatorcontrib>Mirza, Sara H.</creatorcontrib><creatorcontrib>Peev, Vasil</creatorcontrib><creatorcontrib>Anderson, Mark</creatorcontrib><creatorcontrib>Bansal, Anip</creatorcontrib><creatorcontrib>Hayek, Salim S.</creatorcontrib><creatorcontrib>Srivastava, Anand</creatorcontrib><creatorcontrib>Mathews, Kusum S.</creatorcontrib><creatorcontrib>Johns, Tanya S.</creatorcontrib><creatorcontrib>Leonberg-Yoo, Amanda</creatorcontrib><creatorcontrib>Green, Adam</creatorcontrib><creatorcontrib>Arunthamakun, Justin</creatorcontrib><creatorcontrib>Wille, Keith M.</creatorcontrib><creatorcontrib>Shaukat, Tanveer</creatorcontrib><creatorcontrib>Singh, Harkarandeep</creatorcontrib><creatorcontrib>Admon, Andrew J.</creatorcontrib><creatorcontrib>Semler, Matthew W.</creatorcontrib><creatorcontrib>Hernán, Miguel A.</creatorcontrib><creatorcontrib>Mueller, Ariel L.</creatorcontrib><creatorcontrib>Wang, Wei</creatorcontrib><creatorcontrib>Leaf, David E.</creatorcontrib><creatorcontrib>STOP-COVID Investigators</creatorcontrib><creatorcontrib>the STOP-COVID Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaefi, Shahzad</au><au>Brenner, Samantha K.</au><au>Gupta, Shruti</au><au>O’Gara, Brian P.</au><au>Krajewski, Megan L.</au><au>Charytan, David M.</au><au>Chaudhry, Sobaata</au><au>Mirza, Sara H.</au><au>Peev, Vasil</au><au>Anderson, Mark</au><au>Bansal, Anip</au><au>Hayek, Salim S.</au><au>Srivastava, Anand</au><au>Mathews, Kusum S.</au><au>Johns, Tanya S.</au><au>Leonberg-Yoo, Amanda</au><au>Green, Adam</au><au>Arunthamakun, Justin</au><au>Wille, Keith M.</au><au>Shaukat, Tanveer</au><au>Singh, Harkarandeep</au><au>Admon, Andrew J.</au><au>Semler, Matthew W.</au><au>Hernán, Miguel A.</au><au>Mueller, Ariel L.</au><au>Wang, Wei</au><au>Leaf, David E.</au><aucorp>STOP-COVID Investigators</aucorp><aucorp>the STOP-COVID Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>47</volume><issue>2</issue><spage>208</spage><epage>221</epage><pages>208-221</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><abstract>Purpose
Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19).
Methods
We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU admission, using data from a multicenter cohort study of 5122 critically ill adults with COVID-19 admitted to 68 hospitals across the United States. To estimate the effect of ECMO on mortality, we emulated a target trial of ECMO receipt versus no ECMO receipt within 7 days of ICU admission among mechanically ventilated patients with severe hypoxemia (PaO
2
/FiO
2
< 100). Patients were followed until hospital discharge, death, or a minimum of 60 days. We adjusted for confounding using a multivariable Cox model.
Results
Among the 190 patients treated with ECMO, the median age was 49 years (IQR 41–58), 137 (72.1%) were men, and the median PaO
2
/FiO
2
prior to ECMO initiation was 72 (IQR 61–90). At 60 days, 63 patients (33.2%) had died, 94 (49.5%) were discharged, and 33 (17.4%) remained hospitalized. Among the 1297 patients eligible for the target trial emulation, 45 of the 130 (34.6%) who received ECMO died, and 553 of the 1167 (47.4%) who did not receive ECMO died. In the primary analysis, patients who received ECMO had lower mortality than those who did not (HR 0.55; 95% CI 0.41–0.74). Results were similar in a secondary analysis limited to patients with PaO
2
/FiO
2
< 80 (HR 0.55; 95% CI 0.40–0.77).
Conclusion
In select patients with severe respiratory failure from COVID-19, ECMO may reduce mortality.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33528595</pmid><doi>10.1007/s00134-020-06331-9</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-6832-3282</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | Intensive care medicine, 2021-02, Vol.47 (2), p.208-221 |
| issn | 0342-4642 1432-1238 |
| language | eng |
| recordid | cdi_proquest_journals_2488774306 |
| source | MEDLINE; Springer Online Journals Complete |
| subjects | Adult Analysis Anesthesiology Care and treatment Cohort Studies Coronaviruses COVID-19 COVID-19 - complications COVID-19 - therapy Critical Care Medicine Emergency Medicine Extracorporeal Membrane Oxygenation Failure Female Health aspects Humans Hypoxemia Intensive Intensive care Male Medicine Medicine & Public Health Membranes Middle Aged Mortality Original Oxygenation Pain Medicine Patients Pediatrics Pneumology/Respiratory System Respiratory Distress Syndrome - therapy Respiratory Distress Syndrome - virology Respiratory failure Respiratory insufficiency Secondary analysis Treatment Outcome United Kingdom Viral diseases |
| title | Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-20T17%3A09%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Extracorporeal%20membrane%20oxygenation%20in%20patients%20with%20severe%20respiratory%20failure%20from%20COVID-19&rft.jtitle=Intensive%20care%20medicine&rft.au=Shaefi,%20Shahzad&rft.aucorp=STOP-COVID%20Investigators&rft.date=2021-02-01&rft.volume=47&rft.issue=2&rft.spage=208&rft.epage=221&rft.pages=208-221&rft.issn=0342-4642&rft.eissn=1432-1238&rft_id=info:doi/10.1007/s00134-020-06331-9&rft_dat=%3Cgale_pubme%3EA723910622%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2488774306&rft_id=info:pmid/33528595&rft_galeid=A723910622&rfr_iscdi=true |