Clinical Department of Cardiac Anesthesia and Intensive Therapy, Medical University of Silesia, Silesian Centre for Heart Diseases, M.Curie-Sklodowskiej 9, 41-800, Zabrze, Poland.
Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.
Crit Care. 2022 Apr 7;26(1):97. doi: 10.1186/s13054-022-03959-5.
In Poland, the clinical characteristics and outcomes of patients with COVID-19 requiring extracorporeal membrane oxygenation (ECMO) remain unknown. This study aimed to answer these unknowns by analyzing data collected from high-volume ECMO centers willing to participate in this project.
This retrospective, multicenter cohort study was completed between March 1, 2020, and May 31, 2021 (15 months). Data from all patients treated with ECMO for COVID-19 were analyzed. Pre-ECMO laboratory and treatment data were compared between non-survivors and survivors. Independent predictors for death in the intensive care unit (ICU) were identified.
There were 171 patients admitted to participating centers requiring ECMO for refractory hypoxemia due to COVID-19 during the defined time period. A total of 158 patients (mean age: 46.3 ± 9.8 years) were analyzed, and 13 patients were still requiring ECMO at the end of the observation period. Most patients (88%) were treated after October 1, 2020, 77.8% were transferred to ECMO centers from another facility, and 31% were transferred on extracorporeal life support. The mean duration of ECMO therapy was 18.0 ± 13.5 days. The crude ICU mortality rate was 74.1%. In the group of 41 survivors, 37 patients were successfully weaned from ECMO support and four patients underwent a successful lung transplant. In-hospital death was independently associated with pre-ECMO lactate level (OR 2.10 per 1 mmol/L, p = 0.017) and BMI (OR 1.47 per 5 kg/m, p = 0.050).
The ICU mortality rate among patients requiring ECMO for COVID-19 in Poland was high. In-hospital death was independently associated with increased pre-ECMO lactate levels and BMI.
在波兰，需要体外膜肺氧合（ECMO）治疗的 COVID-19 患者的临床特征和结局尚不清楚。本研究旨在通过分析愿意参与该项目的大容量 ECMO 中心收集的数据来回答这些未知问题。
这是一项回顾性、多中心队列研究，于 2020 年 3 月 1 日至 2021 年 5 月 31 日（15 个月）完成。分析了所有因 COVID-19 接受 ECMO 治疗的患者的数据。比较了非幸存者和幸存者的 ECMO 前实验室和治疗数据。确定了 ICU 死亡的独立预测因素。
在规定的时间内，有 171 名患者因 COVID-19 导致难治性低氧血症被收入参与中心需要 ECMO 治疗。共分析了 158 名患者（平均年龄：46.3 ± 9.8 岁），在观察期末仍有 13 名患者需要 ECMO 治疗。大多数患者（88%）是在 2020 年 10 月 1 日后接受治疗的，77.8%是从其他医疗机构转来的 ECMO 中心，31%是在体外生命支持下转来的。ECMO 治疗的平均时间为 18.0 ± 13.5 天。未调整的 ICU 死亡率为 74.1%。在 41 名幸存者中，37 名患者成功脱离 ECMO 支持，4 名患者接受了成功的肺移植。院内死亡与 ECMO 前血乳酸水平（每增加 1mmol/L 的比值比 2.10，p=0.017）和 BMI（每增加 5kg/m 的比值比 1.47，p=0.050）独立相关。
波兰需要 ECMO 治疗的 COVID-19 患者的 ICU 死亡率较高。院内死亡与 ECMO 前血乳酸水平升高和 BMI 独立相关。
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