体外膜肺氧合
医学
生命维持
体外
倾向得分匹配
回顾性队列研究
变向性
2019年冠状病毒病(COVID-19)
单变量分析
急诊医学
重症监护医学
内科学
多元分析
疾病
传染病(医学专业)
作者
Khoa Nguyen,Ahmed Altibi,Pooja Prasad,Srini Mukundan,Kiran Shekar,Kollengode Ramanathan,Bishoy Zakhary
出处
期刊:Asaio Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2024-05-28
卷期号:70 (12): 1040-1045
被引量:3
标识
DOI:10.1097/mat.0000000000002243
摘要
This retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry evaluates the outcomes and identifies risk factors associated with conversion from initial venovenous extracorporeal membrane oxygenation (ECMO) support to venoarterial or hybrid ECMO in patients with coronavirus disease 2019 (COVID-19). We collected deidentified data on all adult patients (≥18 years old) diagnosed with COVID who received venovenous extracorporeal membrane oxygenation between March 2020 and November 2022. Patients initially placed on an ECMO configuration other than venovenous (VV) ECMO were excluded from the analysis. Our analysis included data from 12,850 patients, of which 393 (3.1%) transitioned from VV ECMO to an alternative mode. The primary outcome measure was in-hospital mortality, and the conversion group exhibited a higher in-hospital mortality rate. We also examined baseline variables, including demographic information, biochemical labs, and inotrope requirements. Univariate analysis revealed that pre-ECMO arrest, the need for renal replacement therapy, and the use of inotropic agents, particularly milrinone, were strongly associated with the risk of conversion. Notably, even after implementing a 3:1 propensity score matching, the impact of conversion on both mortality and complications remained substantial. Our study underscores an elevated risk of mortality for COVID-19 patients initially treated with VV ECMO who subsequently require conversion to VA-ECMO or hybrid ECMO.
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