Clinical course of COVID-19 patients treated with ECMO: A multicenter study in Daegu, South Korea
M.D Woo Sung Jang, M.D Jaebum Kim, M.D. c Jonghyun Baek, M.D Hanna Jung, M.D Jae Seok Jang, M.D. e Jae Seok Park, M.D. f Tak-Hyuk Oh, M.D Se Yong Jang, M.D Yun Seok Kim, M.D Yong Shik Kwon
Heart & Lung, doi:10.1016/j.hrtlng.2020.10.010
Background: The COVID-19 pandemic has caused an epidemic of critical patients, some of whom have been treated with extracorporeal membrane oxygenation (ECMO). This purpose of study is to describe the clinical course of COVID-19 patients treated with ECMO. Methods: A multicentered study of critical patients with COVID-19 treated at six hospitals in Daegu was conducted between January and April 2020. Results: Among the 80 patients receiving mechanical ventilation support, 19 (24%) were treated with ECMO included (median age 63.0 years). Eight of the 19 patients (42%) were weaned off ECMO (9.8 days, IQR 7.0-13.7). Among them, four patients were also weaned off mechanical ventilation (33.4 days, IQR 29.3 -35.7), three were still receiving mechanical ventilation (50.9 days), and one expired after ECMO weaning. According to the univariate analysis, the factor that was associated with successful ECMO weaning was vitamin B12 treatment (p = 0.028). Conclusions: During the COVID-19 epidemic, ECMO weaning and mortality rates were 42% and 58%, respectively.
Ethical approval All studies were approved by the national ethics committee.
Declaration of Competing Interests The authors have no conflicts of interest to declare.
References
Alpha, Lawrence, Rajiv, Orlando, Ramesh, Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome, World J Crit Care Med
Alshahrani, Sindi, Alshamsi, Al-Omari, El Tahan et al., Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus, Ann Intensive Care
Arabi, Al-Omari, Mandourah, Al-Hameed, Sindi et al., Critically Ill patients with the middle east respiratory syndrome: A multicenter retrospective cohort study, Crit Care Med
Australia, Jones, Bailey, Beca, Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome, JAMA
Berger, Oudemans-Van Straaten, Vitamin C supplementation in the critically ill patient, Curr Opin Clin Nutr Metab Care
Chen, Zhou, Dong, Qu, Gong et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet
Fisher, Kraskauskas, Martin, Farkas, Wegelin et al., Mechanisms of attenuation of abdominal sepsis induced acute lung injury by ascorbic acid, Am J Physiol Lung Cell Mol Physiol
Fisher, Seropian, Kraskauskas, Thakkae, Voelkel et al., Ascorbic acid attenuates lipopolysaccharide induced acute lung injury, Crit Care Med
Fisher, Seropian, Kraskauskas, Thakkar, Voelkel et al., Ascorbic acid attenuates lipopolysaccharide-induced acute lung injury, Crit Care Med
Force, Ranieri, Rubenfeld, Thompson, Ferguson, Acute respiratory distress syndrome: the Berlin Definition, JAMA
Fowler, Aa, Syed, Knowlson, Sculthorpe et al., Medical respiratory intensive care unit nursing. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis, J Transl Med
Frank, Gutierrez, Jones, Allen, Dobbs, Matthay MA Low tidal volume reduces epithelial and endothelial injury in acid-injured rat lungs, Am J Respir Crit Care Med
Gaies, Gurney, Yen, Napoli, Gajarski et al., Vasoactiveinotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass, Pediatr Crit Care Med
Gattinoni, Tonetti, Cressoni, Cadringher, Herrmann et al., Ventilator-related causes of lung injury: the mechanical power, Intensive Care Med
Goligher, Tomlinson, Hajage, Wijeysundera, Fan et al., Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome and posterior probability of mortality benefit in a post hoc bayesian analysis of a randomized clinical trial, JAMA
Grasso, Stripoli, Mazzone, Pezzuto, Lacitignola et al., Low respiratory rate plus minimally invasive extracorporeal Co2 removal decreases systemic and pulmonary inflammatory mediators in experimental Acute Respiratory Distress Syndrome, Crit Care Med
Huang, Wang, Li, Ren, Zhao et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Jacobs, Stammers, Louis, Hayanga, Firstenberg et al., Extracorporeal membrane oxygenation in the treatment of severe pulmonary and cardiac compromise in coronavirus disease 2019: Experience with 32 patients, ASAIO
Li, Guan, Wu, Wang, Zhou et al., Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia, N Engl J Med
Luyt, Brechot, Demondion, Jovanovic, Hekimian et al., Brain injury during venovenous extracorporeal membrane oxygenation, Intensive Care Med
Noah, Peek, Finney, Griffiths, Harrison et al., Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A(H1N1), JAMA
Osho, Moonsamy, Hibbert, Shelton, Trahanas et al., Venovenous extracorporeal membrane oxygenation for respiratory failure in COVID-19 patients: Early experience from a major academic medical center in North America, Ann Surg
Phelan, Katz, Lo, The novel coronavirus originating in Wuhan, China: Challenges for global health governance, JAMA
Rhodes, Evans, Alhazzani, Levy, Antonelli et al., Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016, Intensive Care Med
Schmidt, Hajage, Lebreton, Monsel, Voiriot et al., Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome associated with COVID-19: A retrospective cohort study, Lancet Respir Med
Schwartz, Munoz, Schneider, Mak, Kaskel et al., New equations to estimate GFR in children with CKD, J Am Soc Nephrol
Wang, Hu, Hu, Zhu, Liu et al., Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, JAMA
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the Chinese center for disease control and prevention, JAMA
Yang, Yu, Xu, Shu, Xia et al., Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study, Lancet Respir Med
Zhang, Hu, Luo, Fang, Li, Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China, J Clin Virol
Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
