Extracorporeal Membrane Oxygenation for SARS-CoV-2 Acute Respiratory Distress Syndrome: A Retrospective Study From Hubei, China

Frontiers in Medicine

article

Xiaobo Yang¹  Jun Yi²  Lu Zhang³  Bing Wang⁴  Zhengqin Xu⁵  Boyi Liu⁶  Yadong Yang⁷  Xiaowei Xiang⁸  Xingguang Qu⁹  Wenhao Xu^1,10  Hunian Li^1,11  Ming Hu^1,12  Zubo Shen^1,13  Changming Yang^1,14  Fengsheng Cao³  Jie Liu^1,11  Zhaohui Zhang⁹  Lianghai Li⁴  Xiaoyun Liu⁵  Ruiting Li¹  Xiaojing Zou¹  Huaqing Shu¹  Yuan Yu¹  Yaqi Ouyang¹  Dan Xu¹  Jiqian Xu¹  Jiancheng Zhang¹  Hong Liu¹  Hong Qi¹  Xuepeng Fan^1,15  Chaolin Huang^1,16  Zhui Yu^1,17  Shiying Yuan¹  Xijing Zhang^1,18  Dingyu Zhang^1,16  You Shang¹  Minghao Fang^2,20  Yingtao Lian^1,17  Yong Peng^2,21  Lingling Wu^1,12  Yongran Wu¹ 

[1] Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of Cardiothoracic Surgery, The First People's Hospital of Jingmeng;Department of Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science;Department of Critical Care Medicine, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University;Department of Critical Care Medicine, Xiangyang No.1 People's Hospital, Affiliated Hospital of Hubei University of Medicine;Department of Critical Care Medicine, Taihe Hospitai Affiliated to Hubei University Medicine;Department of Critical Care Medicine, Huanggang Central Hospital;Department of Critical Care Medicine, Dongfeng Hospital, Affiliated to Hubei University of Medicine;Department of Intensive Care Unit, The First College of Clinical Medical Sciences, China Three Gorges University;Department of Critical Care Medicine, Xiaogan Central Hospital;Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine;Department of Critical Care Medicine, Wuhan Pulmonary Hospital;Department of Critical Care Medicine, Ezhou Central Hospital;Department of Anesthesiology, The First People's Hospital of Jingmeng;Department of Critical Care Medicine, Wuhan No.1 Hospital;Research Center for Translational Medicine, Jinyintan Hospital;Department of Critical Care Medicine, Renmin Hospital of Wuhan University;ICU Center of Xijing Hospital, Airforce Medical University;ICU of Huoshenshan Hospital;Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;Intensive Care Unit, Xiehe Wuhan Red Cross Hospital

关键词: SARS-CoV-2;    COVID-19;    acute respiratory distress syndrome;    extracorporeal membrane oxygenation;    intensive care unit;    prognosis;   

DOI  :  10.3389/fmed.2020.611460

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: The data on long-term outcomes of patients infected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available. Methods: A retrospective study included 73 patients infected by SARS-CoV-2 and treated with ECMO in 21 intensive care units in Hubei, China. Data on demographic information, clinical features, laboratory tests, ECMO durations, complications, and living status were collected. Results: The 73 ECMO-treated patients had a median age of 62 (range 33–78) years and 42 (63.6%) were males. Before ECMO initiation, patients had severe respiratory failure on mechanical ventilation with a median PO 2 /FiO 2 of 71.9 [interquartile range (IQR), 58.6–87.0] mmHg and a median PCO 2 of 62 [IQR, 43–84] mmHg on arterial blood analyses. The median duration from symptom onset to invasive mechanical ventilation, and to ECMO initiation was19 [IQR, 15–25] days, and 23 [IQR, 19–31] days. Before and after ECMO initiation, the proportions of patients receiving prone position ventilation were 58.9 and 69.9%, respectively. The median duration of ECMO support was 18.5 [IQR 12–30] days. During the treatments with ECMO, major hemorrhages occurred in 31 (42.5%) patients, and oxygenators were replaced in 21 (28.8%) patients. Since ECMO initiation, the 30-day mortality and 60-day mortality were 63.0 and 80.8%, respectively. Conclusions: In Hubei, China, the ECMO-treated patients infected by SARS-CoV-2 were of a broad age range and with severe hypoxemia. The durations of ECMO support, accompanied with increased complications, were relatively long. The long-term mortality in these patients was considerably high.

【 授权许可】

CC BY