One-Year Outcomes With Venovenous Extracorporeal Membrane Oxygenation Support for Severe COVID-19.

Autor:	Smith DE; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York. Electronic address: deane.smith@nyulangone.org., Chang SH; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Geraci TC; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., James L; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Kon ZN; Department of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York., Carillo JA; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Alimi M; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Williams D; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Scheinerman JA; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Cerfolio RJ; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Grossi EA; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Moazami N; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York., Galloway AC; Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2022 Jul; Vol. 114 (1), pp. 70-75. Date of Electronic Publication: 2022 Mar 10.
DOI:	10.1016/j.athoracsur.2022.01.003
Abstrakt:	Background: Severe coronavirus disease 2019 (COVID-19) can cause acute respiratory failure requiring mechanical ventilation. Venovenous (VV) extracorporeal membrane oxygenation (ECMO) has been used in patients in whom conventional mechanical ventilatory support has failed. To date, published data have focused on survival from ECMO and survival to discharge. In addition to survival to discharge, this study reports 1-year follow-up data for patients who were successfully discharged from the hospital. Methods: A single-institution, retrospective review of all patients with severe COVID-19 who were cannulated for VV-ECMO between March 10, 2020 and May 1, 2020 was performed. A multidisciplinary ECMO team evaluated, selected, and managed patients with ECMO support. The primary outcome of this study was survival to discharge. Available 1-year follow-up data are also reported. Results: A total of 30 patients were supported with VV-ECMO, and 27 patients (90%) survived to discharge. All patients were discharged home or to acute rehabilitation on room air, except for 1 patient (3.7%), who required supplemental oxygen therapy. At a median follow-up of 10.8 months (interquartile range [IQR], 8.9-14.4 months) since ECMO cannulation, survival was 86.7%, including 1 patient who underwent lung transplantation. Of the patients discharged from the hospital, 44.4% (12/27) had pulmonary function testing, with a median percent predicted forced expiratory volume of 100% (IQR, 91%-110%). For survivors, a 6-minute walk test was performed in 59.3% (16/27), with a median value of 350 m (IQR, 286-379 m). Conclusions: A well-defined patient selection and management strategy of VV-ECMO support in patients with severe COVID-19 resulted in exceptional survival to discharge that was sustained at 1-year after ECMO cannulation. (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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