التفاصيل البيبلوغرافية
| العنوان: |
Transition from Simple V-V to V-A and Hybrid ECMO Configurations in COVID-19 ARDS. |
| المؤلفون: |
Suwalski, Piotr1 (AUTHOR) suwalski.piotr@gmail.com, Staromłyński, Jakub1 (AUTHOR) jakubstaromlynski@gmail.com, Brączkowski, Jakub1 (AUTHOR) kuba.braczkowski@gmail.com, Bartczak, Maciej1 (AUTHOR) mcjbrtczk@gmail.com, Mariani, Silvia2 (AUTHOR) s.mariani1985@gmail.com, Drobiński, Dominik1 (AUTHOR) dominik.drobinski@gmail.com, Szułdrzyński, Konstanty3 (AUTHOR) konstantys@gmail.com, Smoczyński, Radosław1 (AUTHOR) radek.sm@gmail.com, Franczyk, Marzena1 (AUTHOR) marzena.franczyk@cskmswia.pl, Sarnowski, Wojciech1 (AUTHOR) wojciech.sarnowski@cskmswia.pl, Gajewska, Agnieszka1 (AUTHOR) agnieszka.gajewska@cskmswia.pl, Witkowska, Anna1 (AUTHOR) vera@rallywitkowscy.pl, Wierzba, Waldemar4,5 (AUTHOR) wwierzba@post.pl, Zaczyński, Artur4 (AUTHOR) artur.zaczynski@cskmswia.pl, Król, Zbigniew4 (AUTHOR) zbigniew.krol@cskmswia.pl, Olek, Ewa1 (AUTHOR) ewa.olek.98@wp.pl, Pasierski, Michał1 (AUTHOR) michalpasierski@gmail.com, Ravaux, Justine Mafalda2 (AUTHOR) jmravaux@hotmail.com, de Piero, Maria Elena2,6 (AUTHOR) marieledep@gmail.com, Lorusso, Roberto2 (AUTHOR) roberto.lorussobs@gmail.com |
| المصدر: |
Membranes. Jun2021, Vol. 11 Issue 6, p434-434. 1p. |
| مصطلحات موضوعية: |
*INTENSIVE care units, *COVID-19, *ADULT respiratory distress syndrome, *EXTRACORPOREAL membrane oxygenation, *CARDIOLOGICAL manifestations of general diseases, *HYPOVOLEMIC anemia |
| مستخلص: |
In SARS-CoV-2 patients with severe acute respiratory distress syndrome (ARDS), Veno-Venous Extracorporeal Membrane Oxygenation (V-V ECMO) was shown to provide valuable treatment with reasonable survival in large multi-centre investigations. However, in some patients, conversion to modified ECMO support forms may be needed. In this single-centre retrospective registry, all consecutive patients receiving V-V ECMO between 1 March 2020 to 1 May 2021 were included and analysed. The patient cohort was divided into two groups: those who remained on V-V ECMO and those who required conversion to other modalities. Seventy-eight patients were included, with fourteen cases (18%) requiring conversions to veno-arterial (V-A) or hybrid ECMO. The reasons for the ECMO mode configuration change were inadequate drainage (35.7%), inadequate perfusion (14.3%), myocardial infarction (7.1%), hypovolemic shock (14.3%), cardiogenic shock (14.3%) and septic shock (7.1%). In multivariable analysis, the use of dobutamine (p = 0.007) and a shorter ICU duration (p = 0.047) predicted the conversion. The 30-day mortality was higher in converted patients (log-rank p = 0.029). Overall, only 19 patients (24.4%) survived to discharge or lung transplantation. Adverse events were more common after conversion and included renal, cardiovascular and ECMO-circuit complications. Conversion itself was not associated with mortality in the multivariable analysis. In conclusion, as many as 18% of patients undergoing V-V ECMO for COVID-19 ARDS may require conversion to advanced ECMO support. [ABSTRACT FROM AUTHOR] |
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