| Autor: |
Bruni A; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Battaglia C; Radiodiagnostic Institute, Dulbecco Hospital, 88100 Catanzaro, Italy., Bosco V; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Pelaia C; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Neri G; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Biamonte E; Institute of Anesthesia and Intensive Care, Dulbecco Hospital, 88100 Catanzaro, Italy., Manti F; Radiodiagnostic Institute, Dulbecco Hospital, 88100 Catanzaro, Italy., Mollace A; Radiodiagnostic Institute, Dulbecco Hospital, 88100 Catanzaro, Italy., Boscolo A; Department of Medicine (DIMED), University of Padua, 35131 Padua, Italy.; Institute of Anesthesia and Intensive Care, Padua University Hospital, 35122 Padova, Italy.; Thoracic Surgery and Lung Transplant Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35122 Padova, Italy., Morelli M; Department of Obstetrics and Gynecology, 'Annunziata' Hospital, 87100 Cosenza, Italy., Navalesi P; Department of Medicine (DIMED), University of Padua, 35131 Padua, Italy.; Institute of Anesthesia and Intensive Care, Padua University Hospital, 35122 Padova, Italy., Laganà D; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Garofalo E; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Longhini F; Department of Medical and Surgical Sciences, 'Magna Graecia' University, 88100 Catanzaro, Italy., Image Group |
| Abstrakt: |
Background: Acute respiratory distress syndrome (ARDS) presents a significant challenge in critical care settings, characterized by compromised gas exchange, necessitating in the most severe cases interventions such as veno-venous extracorporeal membrane oxygenation (vv-ECMO) when conventional therapies fail. Critically ill ARDS patients on vv-ECMO may experience several complications. Limited data exist comparing complication rates between COVID-19 and non-COVID-19 ARDS patients undergoing vv-ECMO. This retrospective observational study aimed to assess and compare complications in these patient cohorts. Methods: We retrospectively analyzed the medical records of all patients receiving vv-ECMO for ARDS between March 2020 and March 2022. We recorded the baseline characteristics, the disease course and complication (barotrauma, bleeding, thrombosis) before and after ECMO cannulation, and clinical outcomes (mechanical ventilation and ECMO duration, intensive care unit, and hospital lengths of stay and mortalities). Data were compared between COVID-19 and non-COVID-19 patients. In addition, we compared survived and deceased patients. Results: Sixty-four patients were included. COVID-19 patients (n = 25) showed higher rates of pneumothorax (28% vs. 8%, p = 0.039) with subcutaneous emphysema (24% vs. 5%, p = 0.048) and longer non-invasive ventilation duration before vv-ECMO cannulation (2 [1; 4] vs. 0 [0; 1] days, p = <0.001), compared to non-COVID-19 patients (n = 39). However, complication rates and clinical outcomes post-vv-ECMO were similar between groups. Survival analysis revealed no significant differences in pre-vv-ECMO complications, but non-surviving patients had a trend toward higher complication rates and more pleural effusions post-vv-ECMO. Conclusions: COVID-19 patients on vv-ECMO exhibit higher pneumothorax rates with subcutaneous emphysema pre-cannulation; post-cannulation complications are comparable to non-COVID-19 patients. |
