Tang X, Pu L, Zhang J Y, Chao L S, Wang R, Guo D, Qi H S, Wang W S, Yin F Z, Li X Y, Li Y, Yuan X, Du Z T, Xu B, Liu J Y, Yan X X, Sun B
Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University/Beijing Institute of Respiratory Medicine, Beijing 100020, China.
Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Zhonghua Yi Xue Za Zhi. 2021 Mar 2;101(8):579-585. doi: 10.3760/cma.j.cn112137-20201007-02776.
To compare the clinical characteristics and prognosis of critical patients with COVID-19 and novel influenza A (H1N1) virus pneumonia (influenza pneumonia) applied with extracorporeal membrane oxygenation (ECMO). A total of 24 patients with influenza pneumonia treated with ECMO in respiratory intensive-care unit (ICU) of Beijing Chaoyang Hospital from March 2016 to December 2019 and 12 patients with COVID-19 hospitalized from February 1, 2020 to March 31, 2020 in 5 government designated infectious hospitals of Beijing and Hebei Province that applied with ECMO were enrolled. The demographic data, clinical manifestations, and ECMO related information were described and analyzed and all numerical variables are described as (). The age of COVID-19 patients was 77 (66, 79) years old, which was older than influenza pneumonia patients [46 (32, 62) years old], <0.05; acute lung injury score and respiratory ECMO survival prediction (RESP) score before ECMO application were 3.3 (3.0, 3.5) and 1 (0, 2), respectively, which were lower than influenza pneumonia patients [3.8 (3.5, 4.0) and 4 (2, 6), respectively], all values<0.05. Thrombotic complications, bleeding complications, and ventilator-associated pneumonia occurred in ECMO applied COVID-19 patients were 4, 10 and 5 cases, respectively, which were more than that among influenza pneumonia patients (1, 9, and 2 cases, respectively), all values<0.05. The length of ICU stay of COVID-19 patients was 31 (28, 75) d, which was longer than that of influenza pneumonia patients [27 (18, 39) d], <0.05. The cases with successful decannulation of ECMO among COVID-19 and influenza pneumonia patients were 6 and 14 cases, respectively and mortality during ICU stay were 8 cases and 11 cases, respectively, and the difference were not statistically significant (all values>0.05). COVID-19 patients applied with ECMO have more ECMO-related complications and a longer stay in the ICU than patients with influenza pneumonia.
比较接受体外膜肺氧合（ECMO）治疗的新型冠状病毒肺炎（COVID-19）危重症患者与新型甲型H1N1流感病毒肺炎（流感肺炎）患者的临床特征及预后。选取2016年3月至2019年12月在北京朝阳医院呼吸重症监护病房（ICU）接受ECMO治疗的24例流感肺炎患者，以及2020年2月1日至3月31日在北京和河北省5家政府指定传染病医院住院并接受ECMO治疗的12例COVID-19患者。对人口统计学数据、临床表现及ECMO相关信息进行描述和分析，所有数值变量均以（）表示。COVID-19患者年龄为77（66，79）岁，高于流感肺炎患者[46（32，62）岁]，P<0.05；ECMO应用前急性肺损伤评分及呼吸ECMO生存预测（RESP）评分分别为3.3（3.0，3.5）和1（0，2），低于流感肺炎患者[分别为3.8（3.5，4.0）和4（2，6）]，所有P值<0.05。接受ECMO治疗的COVID-19患者发生血栓并发症、出血并发症及呼吸机相关性肺炎的例数分别为4例、10例和5例，多于流感肺炎患者（分别为1例、9例和2例），所有P值<0.05。COVID-19患者ICU住院时间为31（28，75）天，长于流感肺炎患者[27（18，39）天]，P<0.05。COVID-19患者和流感肺炎患者ECMO成功撤机例数分别为6例和14例，ICU住院期间死亡例数分别为8例和11例，差异无统计学意义（所有P值>0.05）。接受ECMO治疗的COVID-19患者比流感肺炎患者有更多的ECMO相关并发症，且在ICU停留时间更长。
