Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019 - 08/01/26
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Abstract |
Background |
Duration of invasive mechanical ventilation (IMV) prior to extracorporeal membrane oxygenation (ECMO) affects outcome in acute respiratory distress syndrome (ARDS). In coronavirus disease 2019 (COVID-19) related ARDS, the role of pre-ECMO IMV duration is unclear. This single-centre, retrospective study included critically ill adults treated with ECMO due to severe COVID-19-related ARDS between 01/2020 and 05/2021. The primary objective was to determine whether duration of IMV prior to ECMO cannulation influenced ICU mortality.
Results |
During the study period, 101 patients (mean age 56 [SD ± 10] years; 70 [69%] men; median RESP score 2 [IQR 1–4]) were treated with ECMO for COVID-19. Sixty patients (59%) survived to ICU discharge. Median ICU length of stay was 31 [IQR 20.7–51] days, median ECMO duration was 16.4 [IQR 8.7–27.7] days, and median time from intubation to ECMO start was 7.7 [IQR 3.6–12.5] days. Fifty-three (52%) patients had a pre-ECMO IMV duration of > 7 days. Pre-ECMO IMV duration had no effect on survival ( p = 0.95). No significant difference in survival was found when patients with a pre-ECMO IMV duration of < 7 days ( < 10 days) were compared to ≥ 7 days (≥ 10 days) ( p = 0.59 and p = 1.0).
Conclusions |
The role of prolonged pre-ECMO IMV duration as a contraindication for ECMO in patients with COVID-19-related ARDS should be scrutinised. Evaluation for ECMO should be assessed on an individual and patient-centred basis.
Le texte complet de cet article est disponible en PDF.Keywords : Acute respiratory distress syndrome, Extracorporeal membrane oxygenation, COVID-19, Invasive mechanical ventilation
Keywords : Medical and Health Sciences, Clinical Sciences, Public Health and Health Services
Plan
Vol 12 - N° 1
Article 6- 2022 Retour au numéro
Article précédent
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