Worldwide application and valuation of extracorporeal membrane oxygenation support during the COVID-19 pandemic (WAVES).

Autor:	Zaaqoq AM; Department of Anesthesiology, Division of Critical Care, University of Virginia, Charlottesville, VA, USA., Heinsar S; Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia.; Department of Intensive Care, North Estonia Medical Centre, Tallinn, Estonia., Yoon HJ; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.; Australian e-Health Research Centre, CSIRO Health & Biosecurity, Australia., White N; Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia.; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia., Griffee MJ; Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA., Suen JY; Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia., Bassi GL; Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia.; Institut D'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain., Fanning JP; Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia., Shehatta AL; Medical Intensive Care Unit, Hamad General Hospital, Weill Cornell Medicine, Doha, Qatar., Alexander PMA; Department of Cardiology, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School, Boston, MA., Jacobs JP; Congenital Heart Center, Division of Cardiovascular Surgery, University of Florida, Gainesville, FL, USA., Dalton HJ; Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, USA., Lorusso R; Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands., Cho SM; Department of Surgery, Division of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.; Departments of Neurology, Anesthesiology, Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Peek GJ; Congenital Heart Center, Division of Cardiovascular Surgery, University of Florida, Gainesville, FL, USA., Fraser JF; Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia.
Jazyk:	angličtina
Zdroj:	Perfusion [Perfusion] 2024 Jul 24, pp. 2676591241267228. Date of Electronic Publication: 2024 Jul 24.
DOI:	10.1177/02676591241267228
Abstrakt:	Objective: The outcomes of COVID-19 patients on venovenous extracorporeal membrane oxygenation (VV-ECMO) varied. We aim to investigate the variability concerning location and timeframe. We conducted a retrospective analysis of data from 351 institutions in 53 countries. The primary outcome was survival to hospital discharge or death up to 90 days from ECMO start. The associations between calendar time (month and year) of ECMO initiation and the primary outcome were examined by Cox regression modeling. Multivariable survival analyses were adjusted for the time of ECMO start, age, body mass index, APACHE II, SOFA, and the duration of mechanical ventilation before ECMO. Results: 1060 adult COVID-19 patients enrolled in the COVID-19 Critical Care Consortium (COVID Critical) international registry and required VV-ECMO support. The study period is from January 2020 to December 2021. The median age was 51 years old, and 70% were male patients. Most patients were from Europe (39.3%) and North America (37.4%). The in-hospital mortality of the entire cohort was 47.12%. In North America and Europe, there was an increased probability of death from May 2020 through February 2021. Latin America showed a steady rate of survival until late in the study. South Asia, the Middle East, and Africa showed an increased chance of mortality around May 2020. In the Asian-Pacific region, after February 2021, there was an increased probability of death. The time of ECMO initiation and advanced patient age were associated with increased mortality. Conclusion: Variability in the outcomes of COVID-19 patients on VV-ECMO existed within different regions. This variability reflects the differences in resources, policies, patient selection, management, and possibly COVID-19 virus subtypes. Our findings might help guide global response in the future by early adoption of patient selection protocols, worldwide policies, and delivery of resources. Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Gianluigi Li Bassi is a recipient of the BITRECS fellowship; the “BITRECS” project has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement no. 754,550 and from the “La Caixa” Foundation (ID 100010434), under the agreement LCF/PR/GN18/50310006. Jacky Y Suen is funded by the Advance Queensland fellowship program. Sung-Min Cho is funded by NIH (1K23HL157610) and serves as a consultant for Hyperfine. Peta Alexander is funded by U.S. DoD PRMRP Clinical Trial Award #W81XWH2210301, NIH (R13HD104432) and FDA UCSF-Stanford Center of Excellence in Regulatory Sciences and Innovation (U01FD004979/U01FD005978). Peta Alexander is Treasurer of ELSO Board of Directors.
Databáze:	MEDLINE
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