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Comparative outcomes between COVID-19 and influenza patients placed on veno-venous extracorporeal membrane oxygenation for severe ARDS.
Raff, Lauren A; Reid, Trista D; Johnson, Daniel; Raff, Evan J; Schneider, Andrew B; Charles, Anthony G; Gallaher, Jared R.
Affiliation
  • Raff LA; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA.
  • Reid TD; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA.
  • Johnson D; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA.
  • Raff EJ; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA.
  • Schneider AB; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA.
  • Charles AG; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA.
  • Gallaher JR; University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, NC, USA. Electronic address: jared_gallaher@med.unc.edu.
Am J Surg ; 223(2): 388-394, 2022 02.
Article in En | MEDLINE | ID: mdl-33894980
BACKGROUND: ECMO is an established supportive adjunct for patients with severe, refractory ARDS from viral pneumonia. However, the exact role and timing of ECMO for COVID-19 patients remains unclear. METHODS: We conducted a retrospective comparison of the first 32 patients with COVID-19-associated ARDS to the last 28 patients with influenza-associated ARDS placed on V-V ECMO. We compared patient factors between the two cohorts and used survival analysis to compare the hazard of mortality over sixty days post-cannulation. RESULTS: COVID-19 patients were older (mean 47.8 vs. 41.2 years, p = 0.033), had more ventilator days before cannulation (mean 4.5 vs. 1.5 days, p < 0.001). Crude in-hospital mortality was significantly higher in the COVID-19 cohort at 65.6% (n = 21/32) versus 36.3% (n = 11/28, p = 0.041). The adjusted hazard ratio over sixty days for COVID-19 patients was 2.81 (95% CI 1.07, 7.35) after adjusting for age, race, ECMO-associated organ failure, and Charlson Comorbidity Index. CONCLUSION: ECMO has a role in severe ARDS associated with COVID-19 but providers should carefully weigh patient factors when utilizing this scarce resource in favor of influenza pneumonia.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Respiratory Distress Syndrome / Extracorporeal Membrane Oxygenation / Influenza, Human / COVID-19 Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Am J Surg Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Respiratory Distress Syndrome / Extracorporeal Membrane Oxygenation / Influenza, Human / COVID-19 Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Am J Surg Year: 2022 Document type: Article