Comparative outcomes between COVID-19 and influenza patients placed on veno-venous extracorporeal membrane oxygenation for severe ARDS

Public Deposited
Analytics

Downloadable Content

Download PDF
Request Version for Screen Reader
Creator
  • Raff, Lauren A.
    • Affiliation: School of Medicine, Department of Surgery
  • Reid, Trista D.
    • Affiliation: School of Medicine, Department of Surgery
  • Johnson, Daniel
    • Affiliation: School of Medicine, Department of Surgery
  • Raff, Evan J.
    • Affiliation: School of Medicine, Department of Surgery
  • Schneider, Andrew B.
    • Affiliation: School of Medicine, Department of Surgery
  • Charles, Anthony G.
    • Affiliation: School of Medicine, Department of Surgery
  • Gallaher, Jared R.
    • Affiliation: School of Medicine, Department of Surgery
Abstract
  • 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.
Date of publication
Keyword
DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Journal title
  • The American Journal of Surgery
Version
  • Postprint
ISSN
  • 0002-9610, 1879-1883

Relations

Parents:

This work has no parents.

In Collection:

Items

Thumbnail Title Date Uploaded Visibility Actions
file details PIIS0002961021002336.pdf 2021-06-07 Public Download