Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus - 08/01/26
, Anees Sindi 2 , Fayez Alshamsi 5 , Awad Al-Omari 6 , Mohamed El Tahan 7 , Bayan Alahmadi 3 , Ahmed Zein 8 , Naif Khatani 3 , Fahad Al-Hameed 4, 9 , Sultan Alamri 10 , Mohammed Abdelzaher 11 , Amenah Alghamdi 12 , Faisal Alfousan 12 , Adel Tash 13 , Wail Tashkandi 14 , Rajaa Alraddadi 15 , Kim Lewis 16 , Mohammed Badawee 17 , Yaseen M. Arabi 18 , Eddy Fan 19 , Waleed Alhazzani 20
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Abstract |
Background |
Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS‐CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies.
Methods |
We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia. Patients were classified into two groups: ECMO versus conventional therapy. Our primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay.
Results |
Thirty-five patients were included; 17 received ECMO and 18 received conventional therapy. Both groups had similar baseline characteristics. The ECMO group had lower in-hospital mortality (65 vs. 100%, P = 0.02), longer ICU stay (median 25 vs. 8 days, respectively, P < 0.01), and similar hospital stay (median 41 vs. 31 days, P = 0.421). In addition, patients in the ECMO group had better PaO2/FiO2 at days 7 and 14 of admission to the ICU (124 vs. 63, and 138 vs. 36, P < 0.05), and less use of norepinephrine at days 1 and 14 (29 vs. 80%; and 36 vs. 93%, P < 0.05).
Conclusions |
ECMO use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV.
Le texte complet de cet article est disponible en PDF.Keywords : Coronavirus infection, Extracorporeal membrane oxygenation, Rescue therapy, Signs and symptoms respiratory
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Vol 8 - N° 1
Article 3- 2018 Retour au numéro
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