{"id":23472,"date":"2023-03-10T04:47:00","date_gmt":"2023-03-09T20:47:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23472"},"modified":"2023-03-10T07:15:42","modified_gmt":"2023-03-09T23:15:42","slug":"lancet-respir-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e5%8f%97ecmo%e6%b2%bb%e7%96%97%e7%9a%84%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e%e6%82%a3%e8%80%85%e4%bd%8f%e9%99%a2%e5%8f%8a6","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23472","title":{"rendered":"[Lancet Respir Med\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u53d7ECMO\u6cbb\u7597\u7684\u65b0\u51a0\u80ba\u708e\u60a3\u8005\u4f4f\u9662\u53ca6\u4e2a\u6708\u9884\u540e"},"content":{"rendered":"\n

ARTICLES|ONLINE FIRST<\/a><\/p>\n\n\n\n

In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study<\/h1>\n\n\n\n

Roberto Lorusso, Maria Elena De Piero, Silvia Mariani, et al.<\/h3>\n\n\n\n

Lancet Respir Med Published:November 16, 2022<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/S2213-2600(22)00403-9<\/a><\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic\u2014from March 1 to Sept 13, 2020\u2014at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov<\/a>, NCT04366921, and is ongoing.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46\u201360]) were included in the study. Median ECMO duration was 15 days (IQR 8\u201327). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients did not die in hospital, and 547 (95%) of 577 patients for whom data were available were alive at 6 months. 102 (24%) of 431 patients had returned to full-time work at 6 months, and 57 (13%) of 428 patients had returned to part-time work. At 6 months, respiratory rehabilitation was required in 88 (17%) of 522 patients with available data, and the most common residual symptoms included dyspnoea (185 [35%] of 523 patients) and cardiac (52 [10%] of 514 patients) or neurocognitive (66 [13%] of 512 patients) symptoms.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Patient's age, timing of cannulation (<4 days vs<\/em> \u22654 days from intubation), and use of inotropes and vasopressors are essential factors to consider when analysing the outcomes of patients receiving ECMO for COVID-19. Despite post-discharge survival being favourable, persisting long-term symptoms suggest that dedicated post-ECMO follow-up programmes are required.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

None.<\/p>\n","protected":false},"excerpt":{"rendered":"

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