Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia.
Department of Intensive Care Medicine and Neuroinfectology, University of Zagreb - School of Medicine, University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia.
Int J Artif Organs. 2022 Jul;45(7):647-651. doi: 10.1177/03913988221092041. Epub 2022 Apr 18.
At the beginning of the COVID 19 pandemic, the outcome of patients treated with ECMO was discouraging. Subsequently, it became clear that a certain group of patients may benefit from ECMO treatment. The primary objective of this study was to compare the outcome of ECMO treatment in COVID-19 and influenza patients referred to a tertiary care center. A total of 119 adult patients required ECMO treatment following ARDS secondary to H1N1 (49) and SARS-CoV-2 (70) in the referral ECMO Center based in Zagreb between October 2009 and October 2021. Our study revealed a significantly higher mortality in COVID-19 patients compared to H1N1 influenza when the onset of ARDS was severe enough to require ECMO support. Based on these results and current knowledge, we argue that ECMO treatment for ARDS in COVID-19 patients is more challenging compared to H1N1 influenza patients. Therefore, referral to the most experienced ECMO centers should be considered. Additionally, patient selection and timing for ECMO treatment play a key role in relation to outcome. Mortality rate in COVID-19 patients requiring ECMO treatment may be used as a reference frame for ECMO centers to ensure best possible care and outcome.
在 COVID-19 大流行初期，接受 ECMO 治疗的患者的预后令人沮丧。随后，很明显，某些患者可能受益于 ECMO 治疗。本研究的主要目的是比较 COVID-19 和流感患者在转至三级护理中心后接受 ECMO 治疗的结局。在 2009 年 10 月至 2021 年 10 月期间，基于萨格勒布的转诊 ECMO 中心，有 119 名成人因 H1N1（49 例）和 SARS-CoV-2（70 例）继发 ARDS 需要 ECMO 治疗。我们的研究表明，与 H1N1 流感相比，COVID-19 患者在 ARDS 发作严重到需要 ECMO 支持时，死亡率明显更高。基于这些结果和当前的知识，我们认为与 H1N1 流感患者相比，COVID-19 患者的 ARDS 接受 ECMO 治疗更具挑战性。因此，应考虑将患者转至经验最丰富的 ECMO 中心。此外，患者选择和 ECMO 治疗时机与结局密切相关。需要 ECMO 治疗的 COVID-19 患者的死亡率可作为 ECMO 中心的参考框架，以确保获得最佳的护理和结局。
