Extracorporeal Membrane Oxygenation for COVID-19-associated Severe Acute Respiratory Distress Syndrome in Chile A Nationwide Incidence and Cohort Study
link https://doi.org/10.1164/rccm.202011-4166OCaccount_box Diaz, Rodrigo A.account_box Graf, Jeronimoaccount_box Zambrano, Jose M.account_box Ruiz, Carolinaaccount_box Espinoza, Juan A.account_box Bravo, Sebastian, Iaccount_box Salazar, Pablo A.account_box Bahamondes, Juan C.account_box Castillo, Luis B.account_box Gajardo, Abraham I. J.account_box Kursbaum, Andresaccount_box Ferreira, Leonila L.account_box Valenzuela, Josefaaccount_box Castillo, Roberto E.account_box Perez-Araos, Rodrigo A.account_box Bravo, Marcelaaccount_box Aquevedo, Andres F.account_box Gonzalez, Mauricio G.account_box Pereira, Rodrigoaccount_box Ortega, Leandroaccount_box Santis, Cesaraccount_box Fernandez, Paula A.account_box Cortes, Vilmaaccount_box Cornejo, Rodrigo A.
Comparte este registro
Rationale: The role of and needs for extracorporeal membrane oxygenation (ECMO) at a population level during the coronavirus disease (COVID-19) pandemic have not been completely established.
Registro Sencillo
Registro Completo
| Autor | Diaz, Rodrigo A. Graf, Jeronimo Zambrano, Jose M. Ruiz, Carolina Espinoza, Juan A. Bravo, Sebastian, I Salazar, Pablo A. Bahamondes, Juan C. Castillo, Luis B. Gajardo, Abraham I. J. Kursbaum, Andres Ferreira, Leonila L. Valenzuela, Josefa Castillo, Roberto E. Perez-Araos, Rodrigo A. Bravo, Marcela Aquevedo, Andres F. Gonzalez, Mauricio G. Pereira, Rodrigo Ortega, Leandro Santis, Cesar Fernandez, Paula A. Cortes, Vilma Cornejo, Rodrigo A. |
| Título | Extracorporeal Membrane Oxygenation for COVID-19-associated Severe Acute Respiratory Distress Syndrome in Chile A Nationwide Incidence and Cohort Study |
| Revista | American journal of respiratory and critical care medicine |
| ISSN | 1073-449X |
| ISSN electrónico | 1535-4970 |
| Volumen | 204 |
| Número de publicación | 1 |
| Página inicio | 34 |
| Página final | 43 |
| Fecha de publicación | 2021 |
| Resumen | Rationale: The role of and needs for extracorporeal membrane oxygenation (ECMO) at a population level during the coronavirus disease (COVID-19) pandemic have not been completely established. Objectives: To identify the cumulative incidence of ECMO use in the first pandemic wave and to describe the Nationwide Chilean cohort of ECMO-supported patients with COVID-19. Methods: We conducted a population-based study from March 3 to August 31, 2020, using linked data from national agencies. The cumulative incidence of ECMO use and mortality risk of ECMO-supported patients were calculated and age standardized. In addition, a retrospective cohort analysis was performed. Outcomes were 90-day mortality after ECMO initiation, ECMO-associated complications, and hospital length of stay. Cox regression models were used to explore risk factors for mortality in a time-to-event analysis. Measurements and Main Results: Ninety-four patients with COVID-19 were supported with ECMO (0.42 per population of 100,000, 14.89 per 100,000 positive cases, and 1.2% of intubated patients with COVID-19); 85 were included in the cohort analysis, and the median age was 48 (interquartile range [IQR], 41-55) years, 83.5% were men, and 42.4% had obesity. The median number of pre-ECMO intubation days was 4 (IQR, 2-7), the median PaO2/FIO2 ratio was 86.8 (IQR, 64-99) mm Hg, 91.8% of patients were prone positioned, and 14 patients had refractory respiratory acidosis. Main complications were infections (70.6%), bleeding (38.8%), and thromboembolism (22.4%); 52 patients were discharged home, and 33 died. The hospital length of stay was a median of 50 (IQR, 24-69) days. Lower respiratory system compliance and higher driving pressure before ECMO initiation were associated with increased mortality. A duration of pre-ECMO intubation >10 days was not associated with mortality. Conclusions: Documenting nationwide ECMO needs may help in planning ECMOprovision for future COVID-19 pandemic waves. The 90-day mortality of the Chilean cohort of ECMO-supported patients with COVID-19 (38.8%) is comparable to that of previous reports. |
| Derechos | acceso restringido |
| DOI | 10.1164/rccm.202011-4166OC |
| Enlace | |
| Id de publicación en WoS | WOS:000674175600011 |
| Palabra clave | extracorporeal membrane oxygenation COVID-19 severe acute respiratory distress syndrome pandemic |
| Tema ODS | 03 Good Health and Well-being |
| Tema ODS español | 03 Salud y bienestar |
| Tipo de documento | artículo |