Characteristics and Outcomes of COVID-19 Patients Supported by Venoarterial or Veno-Arterial-Venous Extracorporeal Membrane Oxygenation.
Characteristics and Outcomes of COVID-19 Patients Supported by Venoarterial or Veno-Arterial-Venous Extracorporeal Membrane Oxygenation.
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DOI：
10.1053/j.jvca.2022.01.049
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发表时间：
2022-08
影响因子：
2.8
通讯作者：
Saeed O
中科院分区：
文献类型：
--
作者：
Haroun MW;Patel SR;Sims DB;Jorde UP;Goldstein DJ;Saeed O
据报道，高达20%至30%的COVID-19患者有心脏损伤，严重的疾病可导致心肺衰竭。机械循环支持在这些患者中的作用仍未确定。作者在此旨在确定需要静脉-动脉-体外膜氧合（VA ECMO）或静脉-动脉-静脉（VAV） ECMO支持的COVID-19患者的特征和结局。多中心回顾性病例系列研究。该队列包括2020年3月1日至2021年4月30日期间确诊COVID-19需要VA ECMO或VAV ECMO支持的成年患者（18岁及以上）。结果记录到2021年7月31日。为了显示住院期间死亡的相关因素，将患者分为幸存者和非幸存者。Kaplan-Meier分析用于估计90天住院死亡率。总的来说，来自12个中心的37名患者组成了研究队列。患者年龄中位数为44岁（四分位数范围[IQR]， 35-52岁），女性患者12例（32%）。ECMO支持时间为2 ~ 132天。随访结束时，13例（35%）患者存活出院或转院，24例（65%）患者在住院期间死亡。90天的累计住院死亡率为64%（95%可信区间：47-81）。在插管至VA ECMO或VAV ECMO启动的时间内（1天[IQR 0-7.5] v 6天[IQR 2.5-14], p = 0.0383），身体质量指数（32 [IQR 26-36] v 37 [IQR 33-40], p = 0.009），基线c -反应蛋白（7.15 v 38.9 mg/dL, p = 0.009）在死亡患者中较高。只有三分之一需要VA ECMO或VAV ECMO的COVID-19患者存活至出院。密切监测早期ECMO伴循环支持的高危患者可能进一步改善预后。
Cardiac injury has been reported in up to 20%-to-30% of patients with COVID-19, and severe disease can lead to cardiopulmonary failure. The role of mechanical circulatory support in these patients remains undetermined. The authors here aimed to determine the characteristics and outcomes of patients with COVID-19 requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) or veno-arterial-venous (VAV) ECMO support. A multicenter, retrospective case series. The cohort consisted of adult patients (18 years of age and older) with confirmed COVID-19 requiring VA ECMO or VAV ECMO support in the period from March 1, 2020, to April 30, 2021. Outcomes were recorded until July 31, 2021. To show factors related to death during hospitalization, patients were grouped as survivors and nonsurvivors. Kaplan-Meier analysis was used to estimate 90-day in-hospital mortality. Overall, 37 patients from 12 centers comprised the study cohort. The median patient age was 44 years old (interquartile range [IQR], 35-52), and 12 (32%) were female patients. The duration of ECMO support ranged from 2-to-132 days. At the end of the follow-up period, 13 patients (35%) were discharged or transferred alive, and 24 patients (65%) died during the hospitalization. The cumulative in-hospital mortality at 90 days was 64% (95% confidence interval: 47-81). During the time from intubation to VA ECMO or VAV ECMO initiation (1 day [IQR 0-7.5] v 6 days [IQR 2.5-14], p = 0.0383), body mass index (32 [IQR 26-36] v 37 [IQR 33-40], p = 0.009), and baseline C-reactive protein (7.15 v 38.9 mg/dL, p = 0.009) were higher in those who expired. Only one-third of the patients with COVID-19 requiring VA ECMO or VAV ECMO survived to discharge. Close monitoring of at-risk patients with early initiation of ECMO with circulatory support may further improve outcomes.
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影响因子：
7.7
作者：
Stringer D;Braude P;Myint PK;Evans L;Collins JT;Verduri A;Quinn TJ;Vilches-Moraga A;Stechman MJ;Pearce L;Moug S;McCarthy K;Hewitt J;Carter B;COPE Study Collaborators
通讯作者：
COPE Study Collaborators
影响因子：
8.8
作者：
Liu, Fang;Li, Lin;Zhou, Xiang
通讯作者：
Zhou, Xiang
DOI：
10.1016/j.jtcvs.2021.04.089
发表时间：
2022-06
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Saeed O;Tatooles AJ;Farooq M;Schwartz G;Pham DT;Mustafa AK;D'Alessandro D;Abrol S;Jorde UP;Gregoric ID;Radovancevic R;Lima B;Bryner BS;Ravichandran A;Salerno CT;Spencer P;Friedmann P;Silvestry S;Goldstein DJ;COVID-19 ECMO Working Group
通讯作者：
COVID-19 ECMO Working Group
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：
4.6
作者：
Cheng, Richard;Hachamovitch, Rory;Azarbal, Babak
通讯作者：
Azarbal, Babak