Early posthospitalization recovery after extracorporeal membrane oxygenation in survivors of COVID-19.
Early posthospitalization recovery after extracorporeal membrane oxygenation in survivors of COVID-19.
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DOI：
10.1016/j.jtcvs.2021.11.099
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发表时间：
2023-09
期刊：
影响因子：
--
通讯作者：
ORACLE group
中科院分区：
文献类型：
--
作者：
Taylor LJ;Jolley SE;Ramani C;Mayer KP;Etchill EW;Mart MF;Fakhri S;Peterson S;Colborn K;Sevin CM;Kadl A;Enfield K;Whitman GJR;Zwischenberger JB;Rove JY;ORACLE group
我们试图确定静脉-静脉体外膜肺氧合（ECMO）对COVID-19机械通气患者出院后前120天内结局的影响。五个学术中心对2020年3月至5月期间收治的COVID-19机械通气患者进行了回顾性分析。幸存者可以进入多学科重症监护后恢复诊所。使用经验证的仪器测量身体、心理和认知缺陷，并根据ECMO状态进行比较。262例机械通气患者与46例静脉-静脉ECMO插管患者进行了比较。接受ECMO的患者更年轻，旅行距离更远，但在性别，种族或体重指数方面没有显着差异。ECMO患者的机械通气持续时间更长（中位数，26天[四分位数范围，19.5-41天] vs 13天[四分位数范围，7-20天]），并且更有可能接受吸入性肺血管扩张剂，神经肌肉阻滞，研究性COVID-19治疗，输血和强心剂。接受ECMO的患者发生更多的出血和凝血事件（P <0.01）。然而，出院时的生存率相似（69.6% vs 70.6%）。在217名幸存者中，65.0%在120天内记录了随访。总体而言，95.5%的患者在家居住，25.7%的患者已恢复工作或日常活动，23.1%的患者仍在使用辅助供氧;这些比率在ECMO状态下无显著差异。生理、心理和认知缺陷的发生率相似。我们的数据表明，COVID-19幸存者在入住重症监护室后会出现严重的身体、心理和认知缺陷。尽管危重病病程更复杂，机械通气平均持续时间更长，平均住院时间更长，但接受静脉-静脉ECMO治疗的患者出院时的生存率和出院后120天内的结局相似。这项回顾性多中心研究检查了COVID-19重症患者在有和没有体外膜肺氧合支持的情况下的住院后结局。
We sought to determine the influence of venovenous extracorporeal membrane oxygenation (ECMO) on outcomes of mechanically ventilated patients with COVID-19 during the first 120 days after hospital discharge. Five academic centers conducted a retrospective analysis of mechanically ventilated patients with COVID-19 admitted during March through May 2020. Survivors had access to a multidisciplinary postintensive care recovery clinic. Physical, psychological, and cognitive deficits were measured using validated instruments and compared based on ECMO status. Two hundred sixty two mechanically ventilated patients were compared with 46 patients cannulated for venovenous ECMO. Patients receiving ECMO were younger and traveled farther but there was no significant difference in gender, race, or body mass index. ECMO patients were mechanically ventilated for longer durations (median, 26 days [interquartile range, 19.5-41 days] vs 13 days [interquartile range, 7-20 days]) and were more likely to receive inhaled pulmonary vasodilators, neuromuscular blockade, investigational COVID-19 therapies, blood transfusions, and inotropes. Patients receiving ECMO experienced greater bleeding and clotting events (P < .01). However, survival at discharge was similar (69.6% vs 70.6%). Of the 217 survivors, 65.0% had documented follow-up within 120 days. Overall, 95.5% were residing at home, 25.7% had returned to work or usual activity, and 23.1% were still using supplemental oxygen; these rates did not differ significantly based on ECMO status. Rates of physical, psychological, and cognitive deficits were similar. Our data suggest that COVID-19 survivors experience significant physical, psychological, and cognitive deficits following intensive care unit admission. Despite a more complex critical illness course, longer average duration of mechanical ventilation, and longer average length of stay, patients treated with venovenous ECMO had similar survival at discharge and outcomes within 120 days of discharge. This retrospective multisite study examined posthospitalization outcomes for critically ill patients with COVID-19 with and without the support of extracorporeal membrane oxygenation.
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影响因子：
8.3
作者：
Taylor, Stephanie Parks;Chou, Shih-Hsiung;Kowalkowski, Marc A.
通讯作者：
Kowalkowski, Marc A.
DOI：
10.1016/s0140-6736(20)32008-0
发表时间：
2020-10-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
Barbaro RP;MacLaren G;Boonstra PS;Iwashyna TJ;Slutsky AS;Fan E;Bartlett RH;Tonna JE;Hyslop R;Fanning JJ;Rycus PT;Hyer SJ;Anders MM;Agerstrand CL;Hryniewicz K;Diaz R;Lorusso R;Combes A;Brodie D;Extracorporeal Life Support Organization
通讯作者：
Extracorporeal Life Support Organization
影响因子：
8.8
作者：
Davidson, Judy E.;Harvey, Maurene A.;Hopkins, Ramona O.
通讯作者：
Hopkins, Ramona O.
影响因子：
168.9
作者：
Peek, Giles J.;Mugford, Miranda;Elbourne, Diana
通讯作者：
Elbourne, Diana
影响因子：
158.5
作者：
Herridge, Margaret S.;Tansey, Catherine M.;Cheung, Angela M.
通讯作者：
Cheung, Angela M.