RT Journal Article
T1 Extracorporeal membrane oxigenation in COVID-19 patients: Results of the ECMO-COVID Registry of the Spanish Society of Cardiovascular and Endovascular Surgery
A1 Castano, Mario
A1 Sbraga, Fabrizio
A1 Perez de la Sota, Enrique
A1 Arribas, Jose M.
A1 Luisa Camara, M.
A1 Voces, Roberto
A1 Donado, Alicia
A1 Sandoval, Elena
A1 Morales, Carlos A.
A1 Gonzalez-Santos, Jose M.
A1 Barquero-Aleman, Miguel
A1 Fletcher-San Feliu, Delfina
A1 Rodriguez-Roda, Jorge
A1 Molina, Daniel
A1 Bellido, Andre
A1 Vigil-Escalera, Carlota
A1 Tena, M. Angeles
A1 Reyes, Guillermo
A1 Gomez, Felix
A1 Rivas, Jorge
A1 Guevara, Audelio
A1 Tauron, Manel
A1 Miguel Borrego, Jose
A1 Castillo, Laura
A1 Miralles, Albert
A1 Canovas, Sergio
A1 Berastegui, Elisabet
A1 Aramendi, Jose, I
A1 Aldamiz, Gonzalo
A1 Pruna, Robert
A1 Silva, Jacobo
A1 Saez de Ibarra, Jose I.
A1 Legarra, Juan J.
A1 Ballester, Carlos
A1 Rodriguez-Lecoq, Rafael
A1 Daroca, Tomas
A1 Paredes, Federico
K1 Extracorporeal membrane oxygenation
K1 ECMO
K1 COVID-19
K1 Heart failure
K1 Respiratory failure
K1 Respiratory-distress-syndrome
K1 Oxygenation
K1 Support
K1 Guidelines
K1 Failure
K1 Trial
AB Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO.Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge.Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support; Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 +/- 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence.Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization. (C) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.
PB Elsevier
SN 1134-0096
YR 2022
FD 2022-04-08
LK http://hdl.handle.net/10668/22093
UL http://hdl.handle.net/10668/22093
LA es
DS RISalud
RD Apr 11, 2025