| Autor: |
Johannes Herrmann, Christopher Lotz, Christian Karagiannidis, Steffen Weber-Carstens, Stefan Kluge, Christian Putensen, Andreas Wehrfritz, Karsten Schmidt, Richard K. Ellerkmann, Daniel Oswald, Gösta Lotz, Viviane Zotzmann, Onnen Moerer, Christian Kühn, Matthias Kochanek, Ralf Muellenbach, Matthias Gaertner, Falk Fichtner, Florian Brettner, Michael Findeisen, Markus Heim, Tobias Lahmer, Felix Rosenow, Nils Haake, Philipp M. Lepper, Peter Rosenberger, Stephan Braune, Mirjam Kohls, Peter Heuschmann, Patrick Meybohm, for the German ECMO COVID Study Group |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Critical Care, Vol 26, Iss 1, Pp 1-14 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
1364-8535 |
| DOI: |
10.1186/s13054-022-04053-6 |
| Popis: |
Abstract Background Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients. Methods 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival. Results Most patients were between 50 and 70 years of age. PaO2/FiO2 ratio prior to ECMO was 72 mmHg (IQR: 58–99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41–0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28–1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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Full text from SpringerLink