Comparison of Extracorporeal Membrane Oxygenation Survivors with Non-Survivors; A Retrospective Analysis at a Quaternary Center

Yaqoob, Hamid; Henson, Theresa; Greenberg, Daniel J.; Peneyra, D.; Huang, L.; Pitaktong, A.; Epelbaum, Oleg; Chandy, Dipak

doi:10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4287

Cited by 1 publication

(2 citation statements)

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“…Of the total articles, twentyfour studies were conducted in the Americas (twenty-two in the United States of America (USA) [19][20][21]24,25,32,34,35,38,39,46,47,52,54,55,57,58,61,65,66,68,70], one in Argentina [26], one in Chile [29]), twenty-three in Europe (nine in France [22,29,33,42,44,49,50,59,60], six in Germany [31,37,41,48,62,71], two in the United Kingdom of Great Britain and Northern Ireland (UK) [27,72], two in Spain [51,56], one in Finland [23], one in Austria [36], one in Poland [64], one in Italy [45]), seven in Asia (three in China [28,…”

Section: Study Characteristicsmentioning

confidence: 99%

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Relationship between the Pre-ECMO and ECMO Time and Survival of Severe COVID-19 Patients: A Systematic Review and Meta-Analysis

Tan,

Su,

Chen

et al. 2024

JCM

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Background: Coronavirus disease 2019 (COVID-19) is the etiology of acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) is used to support gas exchange in patients who have failed conventional mechanical ventilation. However, there is no clear consensus on the timing of ECMO use in severe COVID-19 patients. Objective: The aim of this study is to compare the differences in pre-ECMO time and ECMO duration between COVID-19 survivors and non-survivors and to explore the association between them. Methods: PubMed, the Cochrane Library, Embase, and other sources were searched until 21 October 2022. Studies reporting the relationship between ECMO-related time and COVID-19 survival were included. All available data were pooled using random-effects methods. Linear regression analysis was used to determine the correlation between pre-ECMO time and ECMO duration. The meta-analysis was registered with PROSPERO under registration number CRD42023403236. Results: Out of the initial 2473 citations, we analyzed 318 full-text articles, and 54 studies were included, involving 13,691 patients. There were significant differences between survivors and non-survivors in the time from COVID-19 diagnosis (standardized mean difference (SMD) = −0.41, 95% confidence interval (CI): [−0.53, −0.29], p < 0.00001), hospital (SMD = −0.53, 95% CI: [−0.97, −0.09], p = 0.02) and intensive care unit (ICU) admission (SMD = −0.28, 95% CI: [−0.49, −0.08], p = 0.007), intubation or mechanical ventilation to ECMO (SMD = −0.21, 95% CI: [−0.32, −0.09], p = 0.0003) and ECMO duration (SMD = −0.18, 95% CI: [−0.30, −0.06], p = 0.003). There was no statistical association between a longer time from symptom onset to ECMO (hazard ratio (HR) = 1.05, 95% CI: [0.99, 1.12], p = 0.11) or time from intubation or mechanical ventilation (MV) and the risk of mortality (highest vs. lowest time groups odds ratio (OR) = 1.18, 95% CI: [0.78, 1.78], p = 0.42; per one-day increase OR = 1.14, 95% CI: [0.86, 1.52], p = 0.36; HR = 0.99, 95% CI: [0.95, 1.02], p = 0.39). There was no linear relationship between pre-ECMO time and ECMO duration. Conclusion: There are differences in pre-ECMO time between COVID-19 survivors and non-survivors, and there is insufficient evidence to conclude that longer pre-ECMO time is responsible for reduced survival in COVID-19 patients. ECMO duration differed between survivors and non-survivors, and the timing of pre-ECMO does not have an impact on ECMO duration. Further studies are needed to explore the association between pre-ECMO and ECMO time in the survival of COVID-19 patients.

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Section: Study Characteristicsmentioning

confidence: 99%

“…Of the fifty-four included articles, five studies had an NOS score of five [51,63,65,68,69], and twenty-three had a score of six [20,[24][25][26][27]32,35,38,40,[43][44][45][46][47][48]50,52,64,66,67,[70][71][72]. Effect sizes and follow-up times were not reported, raising concerns about selection and outcome bias.…”

Section: Quality Evaluationmentioning

confidence: 99%