Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019.
Acute respiratory distress syndrome
COVID-19
Extracorporeal membrane oxygenation
Invasive mechanical ventilation
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
13 Jan 2022
13 Jan 2022
Historique:
received:
14
10
2021
accepted:
02
01
2022
entrez:
13
1
2022
pubmed:
14
1
2022
medline:
14
1
2022
Statut:
epublish
Résumé
Duration of invasive mechanical ventilation (IMV) prior to extracorporeal membrane oxygenation (ECMO) affects outcome in acute respiratory distress syndrome (ARDS). In coronavirus disease 2019 (COVID-19) related ARDS, the role of pre-ECMO IMV duration is unclear. This single-centre, retrospective study included critically ill adults treated with ECMO due to severe COVID-19-related ARDS between 01/2020 and 05/2021. The primary objective was to determine whether duration of IMV prior to ECMO cannulation influenced ICU mortality. During the study period, 101 patients (mean age 56 [SD ± 10] years; 70 [69%] men; median RESP score 2 [IQR 1-4]) were treated with ECMO for COVID-19. Sixty patients (59%) survived to ICU discharge. Median ICU length of stay was 31 [IQR 20.7-51] days, median ECMO duration was 16.4 [IQR 8.7-27.7] days, and median time from intubation to ECMO start was 7.7 [IQR 3.6-12.5] days. Fifty-three (52%) patients had a pre-ECMO IMV duration of > 7 days. Pre-ECMO IMV duration had no effect on survival (p = 0.95). No significant difference in survival was found when patients with a pre-ECMO IMV duration of < 7 days (< 10 days) were compared to ≥ 7 days (≥ 10 days) (p = 0.59 and p = 1.0). The role of prolonged pre-ECMO IMV duration as a contraindication for ECMO in patients with COVID-19-related ARDS should be scrutinised. Evaluation for ECMO should be assessed on an individual and patient-centred basis.
Sections du résumé
BACKGROUND
BACKGROUND
Duration of invasive mechanical ventilation (IMV) prior to extracorporeal membrane oxygenation (ECMO) affects outcome in acute respiratory distress syndrome (ARDS). In coronavirus disease 2019 (COVID-19) related ARDS, the role of pre-ECMO IMV duration is unclear. This single-centre, retrospective study included critically ill adults treated with ECMO due to severe COVID-19-related ARDS between 01/2020 and 05/2021. The primary objective was to determine whether duration of IMV prior to ECMO cannulation influenced ICU mortality.
RESULTS
RESULTS
During the study period, 101 patients (mean age 56 [SD ± 10] years; 70 [69%] men; median RESP score 2 [IQR 1-4]) were treated with ECMO for COVID-19. Sixty patients (59%) survived to ICU discharge. Median ICU length of stay was 31 [IQR 20.7-51] days, median ECMO duration was 16.4 [IQR 8.7-27.7] days, and median time from intubation to ECMO start was 7.7 [IQR 3.6-12.5] days. Fifty-three (52%) patients had a pre-ECMO IMV duration of > 7 days. Pre-ECMO IMV duration had no effect on survival (p = 0.95). No significant difference in survival was found when patients with a pre-ECMO IMV duration of < 7 days (< 10 days) were compared to ≥ 7 days (≥ 10 days) (p = 0.59 and p = 1.0).
CONCLUSIONS
CONCLUSIONS
The role of prolonged pre-ECMO IMV duration as a contraindication for ECMO in patients with COVID-19-related ARDS should be scrutinised. Evaluation for ECMO should be assessed on an individual and patient-centred basis.
Identifiants
pubmed: 35024972
doi: 10.1186/s13613-022-00980-3
pii: 10.1186/s13613-022-00980-3
pmc: PMC8755897
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6Informations de copyright
© 2022. The Author(s).
Références
Network C-IGobotR, the C-ICUI. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive Care Med. 2021;47(1):60–73.
Combes A, Hajage D, Capellier G, Demoule A, Lavoue S, Guervilly C, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018;378(21):1965–75.
doi: 10.1056/NEJMoa1800385
Shekar K, Badulak J, Peek G, Boeken U, Dalton HJ, Arora L, et al. Extracorporeal life support organization coronavirus disease 2019 interim guidelines: a consensus document from an international group of interdisciplinary extracorporeal membrane oxygenation providers. ASAIO J. 2020;66(7):707–21.
doi: 10.1097/MAT.0000000000001193
Bartlett RH, Ogino MT, Brodie D, McMullan DM, Lorusso R, MacLaren G, et al. Initial ELSO guidance document: ECMO for COVID-19 patients with severe cardiopulmonary failure. ASAIO J. 2020;66(5):472–4.
doi: 10.1097/MAT.0000000000001173
Lebreton G, Schmidt M, Ponnaiah M, Folliguet T, Para M, Guihaire J, et al. Extracorporeal membrane oxygenation network organisation and clinical outcomes during the COVID-19 pandemic in Greater Paris, France: a multicentre cohort study. Lancet Respir Med. 2021;9(8):851–62.
doi: 10.1016/S2213-2600(21)00096-5
Schmidt M, Hajage D, Lebreton G, Monsel A, Voiriot G, Levy D, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome associated with COVID-19: a retrospective cohort study. Lancet Respir Med. 2020;8(11):1121–31.
doi: 10.1016/S2213-2600(20)30328-3
Schmidt M, Bailey M, Sheldrake J, Hodgson C, Aubron C, Rycus PT, et al. Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure. The Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score. Am J Respir Crit Care Med. 2014;189(11):1374–82.
doi: 10.1164/rccm.201311-2023OC
Schmidt M, Zogheib E, Roze H, Repesse X, Lebreton G, Luyt CE, et al. The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Intensive Care Med. 2013;39(10):1704–13.
doi: 10.1007/s00134-013-3037-2
Wu MY, Huang CC, Wu TI, Chang YS, Wang CL, Lin PJ. Is there a preinterventional mechanical ventilation time limit for candidates of adult respiratory extracorporeal membrane oxygenation. ASAIO J. 2017;63(5):650–8.
doi: 10.1097/MAT.0000000000000577
Tonna JE, Abrams D, Brodie D, Greenwood JC, Rubio Mateo-Sidron JA, Usman A, et al. Management of Adult Patients Supported with Venovenous Extracorporeal Membrane Oxygenation (VV ECMO): Guideline from the Extracorporeal Life Support Organization (ELSO). ASAIO J. 2021;67(6):601–10.
doi: 10.1097/MAT.0000000000001432
Wiedemann D, Bernardi MH, Distelmaier K, Goliasch G, Hengstenberg C, Hermann A, et al. Recommendations for extracorporeal membrane oxygenation (ECMO) in COVID-19 patients : Consensus paper of the Medical University of Vienna. Wien Klin Wochenschr. 2020;132(21–22):671–6.
doi: 10.1007/s00508-020-01708-8
Zochios V, Brodie D, Charlesworth M, Parhar KK. Delivering extracorporeal membrane oxygenation for patients with COVID-19: what, who, when and how? Anaesthesia. 2020;75(8):997–1001.
doi: 10.1111/anae.15099
Matthay MA, Aldrich JM, Gotts JE. Treatment for severe acute respiratory distress syndrome from COVID-19. Lancet Respir Med. 2020;8(5):433–4.
doi: 10.1016/S2213-2600(20)30127-2
Barbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E, et al. Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet. 2020;396(10257):1071–8.
doi: 10.1016/S0140-6736(20)32008-0
Diaz RA, Graf J, Zambrano JM, Ruiz C, Espinoza JA, Bravo SI, et al. ECMO for COVID-19-Associated Severe ARDS in Chile: A Nationwide Incidence and Cohort Study. Am J Respir Crit Care Med. 2021;204(1):34–43.
doi: 10.1164/rccm.202011-4166OC
Shaefi S, Brenner SK, Gupta S, O’Gara BP, Krajewski ML, Charytan DM, et al. Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19. Intensive Care Med. 2021;47(2):208–21.
doi: 10.1007/s00134-020-06331-9
Daviet F, Guilloux P, Hraiech S, Tonon D, Velly L, Bourenne J, et al. Impact of obesity on survival in COVID-19 ARDS patients receiving ECMO: results from an ambispective observational cohort. Ann Intensive Care. 2021;11(1):157.
doi: 10.1186/s13613-021-00943-0
Karagiannidis C, Strassmann S, Merten M, Bein T, Windisch W, Meybohm P, et al. High In-Hospital Mortality in COVID patients receiving ECMO in Germany—a critical analysis. Am J Respir Crit Care Med. 2021;204(8):991–4.
doi: 10.1164/rccm.202105-1145LE
Giraud R, Legouis D, Assouline B, De Charriere A, Decosterd D, Brunner ME, et al. Timing of VV-ECMO therapy implementation influences prognosis of COVID-19 patients. Physiol Rep. 2021;9(3):e14715.
doi: 10.14814/phy2.14715
Brogan TV, Thiagarajan RR, Rycus PT, Bartlett RH, Bratton SL. Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database. Intensive Care Med. 2009;35(12):2105–14.
doi: 10.1007/s00134-009-1661-7
Hemmila MR, Rowe SA, Boules TN, Miskulin J, McGillicuddy JW, Schuerer DJ, et al. Extracorporeal life support for severe acute respiratory distress syndrome in adults. Ann Surg. 2004;240(4):595–605.
doi: 10.1097/01.sla.0000141159.90676.2d
Augoustides JG. Extracorporeal membrane oxygenation—crucial considerations during the coronavirus crisis. J Cardiothorac Vasc Anesth. 2020;34(7):1720–2.
doi: 10.1053/j.jvca.2020.03.060
Shah A, Dave S, Galvagno S, George K, Menne AR, Haase DJ, et al. A Dedicated Veno-Venous Extracorporeal Membrane Oxygenation Unit during a Respiratory Pandemic: Lessons Learned from COVID-19 Part II: Clinical Management. Membranes (Basel). 2021;11:5.
MacLaren G, Combes A, Brodie D. What’s new in ECMO for COVID-19? Intensive Care Med. 2021;47(1):107–9.
doi: 10.1007/s00134-020-06284-z
Schmidt M, Pham T, Arcadipane A, Agerstrand C, Ohshimo S, Pellegrino V, et al. Mechanical Ventilation Management during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome. An International Multicenter Prospective Cohort. Am J Respir Crit Care Med. 2019;200(8):1002–12.
doi: 10.1164/rccm.201806-1094OC
Barbaro RP, MacLaren G, Boonstra PS, Combes A, Agerstrand C, Annich G, et al. Extracorporeal membrane oxygenation for COVID-19: evolving outcomes from the international Extracorporeal Life Support Organization Registry. Lancet. 2021;398(10307):1230–8.
doi: 10.1016/S0140-6736(21)01960-7
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region Italy. JAMA. 2020;323(16):1574–81.
doi: 10.1001/jama.2020.5394
Luyt CE, Sahnoun T, Gautier M, Vidal P, Burrel S, de Chambrun M, et al. Ventilator-associated pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: a retrospective cohort study. Ann Intensive Care. 2020;10(1):158.
doi: 10.1186/s13613-020-00775-4
Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430–6.
doi: 10.1038/s41586-020-2521-4
Ramanathan K, Shekar K, Ling RR, Barbaro RP, Wong SN, Tan CS, et al. Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Crit Care. 2021;25(1):211.
doi: 10.1186/s13054-021-03634-1
Bharat A, Machuca TN, Querrey M, Kurihara C, Garza-Castillon R Jr, Kim S, et al. Early outcomes after lung transplantation for severe COVID-19: a series of the first consecutive cases from four countries. Lancet Respir Med. 2021;9(5):487–97.
doi: 10.1016/S2213-2600(21)00077-1
Carfi A, Bernabei R, Landi F, Gemelli Against C-P-ACSG. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603–5.
Hajjar LA, Costa I, Rizk SI, Biselli B, Gomes BR, Bittar CS, et al. Intensive care management of patients with COVID-19: a practical approach. Ann Intensive Care. 2021;11(1):36.
doi: 10.1186/s13613-021-00820-w