Lee Soojin, Kang Gayeon, Song Seunghwan, Lee Kwangha, Yoo Wanho, Jang Hyojin, Jang Myung Hun
Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.
Division of Pulmonary, Allergy, and Critical Care Medicine, Biomedical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea.
J Clin Med. 2024 Oct 4;13(19):5922. doi: 10.3390/jcm13195922.
The World Health Organization recommends extracorporeal membrane oxygenation (ECMO) as a therapeutic option for the most critical cases of severe coronavirus disease 2019 (COVID-19). However, data on universally agreed-upon risk factors that contribute to ECMO weaning failure and mortality in COVID-19 patients undergoing ECMO are limited. This lack of consensus leads to significant uncertainties in developing effective management strategies for these patients. We aimed to identify the factors associated with early outcomes after ECMO support in patients with COVID-19-induced acute respiratory distress syndrome, specifically the success rate of ECMO weaning and in-hospital mortality. We reviewed 25 patients with COVID-19 who received ECMO support at a single institution between January 2020 and July 2022. This retrospective data collection and review included clinical characteristics, adjunctive treatments, complications, and early patient outcomes. A total of 72% of the patients were successfully weaned off ECMO, and 68% were discharged alive. Significant associations were observed between ECMO weaning success and in-hospital survival, particularly younger age and a history of rehabilitation therapy. Furthermore, the absence of a history of immunosuppressive therapy contributed significantly to successful ECMO weaning. Younger age and the implementation of rehabilitation therapy are associated with improved outcomes in patients with COVID-19 receiving ECMO support.
世界卫生组织推荐将体外膜肺氧合(ECMO)作为治疗2019年冠状病毒病(COVID-19)最严重病例的一种治疗选择。然而,关于导致接受ECMO治疗的COVID-19患者ECMO撤机失败和死亡的普遍认可的风险因素的数据有限。这种缺乏共识的情况导致在为这些患者制定有效的管理策略时存在重大不确定性。我们旨在确定与COVID-19诱发的急性呼吸窘迫综合征患者接受ECMO支持后的早期结局相关的因素,特别是ECMO撤机成功率和住院死亡率。我们回顾了2020年1月至2022年7月期间在一家机构接受ECMO支持的25例COVID-19患者。这种回顾性数据收集和审查包括临床特征、辅助治疗、并发症和患者早期结局。共有72%的患者成功撤机,68%的患者存活出院。观察到ECMO撤机成功与住院生存之间存在显著关联,尤其是年龄较小和有康复治疗史。此外,没有免疫抑制治疗史对ECMO成功撤机有显著贡献。年龄较小和实施康复治疗与接受ECMO支持的COVID-19患者的结局改善相关。