Survival benefit of extracorporeal membrane oxygenation in severe COVID-19: a multi-centre-matched cohort study.


Journal

Intensive care medicine
ISSN: 1432-1238
Titre abrégé: Intensive Care Med
Pays: United States
ID NLM: 7704851

Informations de publication

Date de publication:
04 2022
Historique:
received: 29 11 2021
accepted: 07 02 2022
pubmed: 4 3 2022
medline: 30 3 2022
entrez: 3 3 2022
Statut: ppublish

Résumé

Extracorporeal membrane oxygenation (ECMO) has become an established therapy for severe respiratory failure in coronavirus disease 2019 (COVID-19). The added benefit of receiving ECMO in COVID-19 remains uncertain. The aim of this study is to analyse the impact of receiving ECMO at specialist centres on hospital mortality. A multi-centre retrospective study was conducted in COVID-19 patients from 111 hospitals, referred to two specialist ECMO centres in the United Kingdom (UK) (March 2020 to February 2021). Detailed covariate data were contemporaneously curated from electronic referral systems. We analysed added benefit of ECMO treatment in specialist centres using propensity score matching techniques. 1363 patients, 243 receiving ECMO, were analysed. The best matching technique generated 209 matches, with a marginal odds ratio (OR) for mortality of 0.44 (95% CI 0.29-0.68, p < 0.001) and absolute mortality reduction of 18.2% (44% vs 25.8%, p < 0.001) for treatment with ECMO in a specialist centre. We found ECMO provided at specialist centres conferred significant survival benefit. Where resources and specialism allow, ECMO should be widely offered.

Identifiants

pubmed: 35238946
doi: 10.1007/s00134-022-06645-w
pii: 10.1007/s00134-022-06645-w
pmc: PMC8892395
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

467-478

Commentaires et corrections

Type : ErratumIn
Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Stephen Whebell (S)

Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK. swhebell@gmail.com.
Department of Adult Critical Care, St Thomas' Hospital, London, SE1 7EH, UK. swhebell@gmail.com.

Joe Zhang (J)

Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
Institute of Global Health Innovation, Imperial College London, London, UK.

Rebecca Lewis (R)

Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Michael Berry (M)

Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.

Stephane Ledot (S)

Department of Adult Intensive Care, Royal Brompton and Harefield NHS Foundation Trust, London, UK.

Andrew Retter (A)

Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Luigi Camporota (L)

Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.

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