High In-Hospital Mortality Rate in Patients with COVID-19 Receiving Extracorporeal Membrane Oxygenation in Germany: A Critical Analysis

Karagiannidis, Christian; Straßmann, Stephan; Merten, Michaela; Bein, Thomas; Windisch, Wolfram; Meybohm, Patrick; Weber‐Carstens, Steffen

doi:10.1164/rccm.202105-1145le

Cited by 52 publications

(63 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As already discussed previously, age is a well-established risk factor for worse outcomes. Comorbidities were not different between the two wave groups and similar to other large cohort studies [ 20 , 33 , 34 , 35 , 36 , 38 ]. Otherwise, the patients during the second wave were prone to manifest higher severity of pulmonary involvement even if they had less extra-pulmonary organ dysfunction.…”

Section: Discussionsupporting

confidence: 89%

“…This is comparable to the mean age of 57.7 (±11.4) years in the study by Karagiannidis et al [38] but is significantly higher than previous studies with a mean age ranging from 48 (±11) to 55.4 (±9.3) years [20,[34][35][36]. Increasing age is one of important pre-ECMO variables associated with a worse outcome, as demonstrated by many studies [20,34,38,39]. Another factor, contributing to the higher mortality rates in our cohort, may be the median SAPSII (58 (34-67)) higher than the ones reported by Schmidt et al [35] (median 45 (29-56)) and by )) [34].…”

Section: Discussionsupporting

confidence: 89%

“…The reasons for the high in-hospital mortality in our cohort might be the higher mean age of 58 (±10) years in the whole cohort. This is comparable to the mean age of 57.7 (±11.4) years in the study by Karagiannidis et al [ 38 ] but is significantly higher than previous studies with a mean age ranging from 48 (±11) to 55.4 (±9.3) years [ 20 , 34 , 35 , 36 ]. Increasing age is one of important pre-ECMO variables associated with a worse outcome, as demonstrated by many studies [ 20 , 34 , 38 , 39 ].…”

Section: Discussionsupporting

confidence: 84%

“…However, all of these studies took place solely during the first wave of COVID-19’s pandemic. In contrast, other studies reported a comparable high mortality such as a recent multicenter study in Germany involving a total of 768 COVID-19 ECMO patients admitted to hospitals between February and December 2020 with a 73% in-hospital mortality [ 38 ]. The reasons for the high in-hospital mortality in our cohort might be the higher mean age of 58 (±10) years in the whole cohort.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Extracorporeal Membrane Oxygenation for COVID 2019-Acute Respiratory Distress Syndrome: Comparison between First and Second Waves (Stage 2)

Dognon

Gaudet

Parmentier-Decrucq

et al. 2021

JCM

View full text Add to dashboard Cite

We aimed to compare the outcomes of patients under veno-venous extracorporeal membrane oxygenation (V-V ECMO) for COVID-19-Acute Respiratory Distress Syndrome (CARDS) between the first and the second wave. From 1 March 2020 to 30 November 2020, fifty patients requiring a V-V ECMO support for CARDS were included. Patient demographics, pre-ECMO, and day one, three, and seven on-ECMO data and outcomes were collected. The 90-day mortality was 11% higher during the second wave (18/26 (69%)) compared to the first wave (14/24 (58%) (p = 0.423). During the second wave, all of the patients were given steroids compared to 16.7% during the first wave (p < 0.001). The second wave’s patients had been on non-invasive ventilation support for a longer period than in the first wave, with the median time from ICU admission to ECMO implantation being significantly higher (14 (11–20) vs. 7.7 (5–12) days; p < 0.001). Mechanical properties of the lung were worsened in the second wave’s CARDS patients before ECMO implantation (median static compliance 20 (16–26) vs. 29 (25–37) mL/cmH2O; p < 0.001) and during ECMO days one, three, and seven. More bacterial co-infections before implantation and under ECMO were documented in the second wave group. Despite a better evidence-driven critical care management, we depicted fewer encouraging outcomes during the second wave.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Extracorporeal Membrane Oxygenation for COVID 2019-Acute Respiratory Distress Syndrome: Comparison between First and Second Waves (Stage 2)

Dognon

Gaudet

Parmentier-Decrucq

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Although some data show the lowest mortality of COVID-19 patients when ECMO initiation takes place within the first three to four days following intubation [ 18 , 19 ], the current literature provides no clear cut-off for the maximum antecedent time on IMV. In non-COVID-19-associated ARDS, a duration > 7 days has been associated with increased mortality, which is why ECMO initiation, once indicated, should not be delayed [ 7 – 9 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019

Hermann

Laxar

Krall

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

Background Duration of invasive mechanical ventilation (IMV) prior to extracorporeal membrane oxygenation (ECMO) affects outcome in acute respiratory distress syndrome (ARDS). In coronavirus disease 2019 (COVID-19) related ARDS, the role of pre-ECMO IMV duration is unclear. This single-centre, retrospective study included critically ill adults treated with ECMO due to severe COVID-19-related ARDS between 01/2020 and 05/2021. The primary objective was to determine whether duration of IMV prior to ECMO cannulation influenced ICU mortality. Results During the study period, 101 patients (mean age 56 [SD ± 10] years; 70 [69%] men; median RESP score 2 [IQR 1–4]) were treated with ECMO for COVID-19. Sixty patients (59%) survived to ICU discharge. Median ICU length of stay was 31 [IQR 20.7–51] days, median ECMO duration was 16.4 [IQR 8.7–27.7] days, and median time from intubation to ECMO start was 7.7 [IQR 3.6–12.5] days. Fifty-three (52%) patients had a pre-ECMO IMV duration of > 7 days. Pre-ECMO IMV duration had no effect on survival (p = 0.95). No significant difference in survival was found when patients with a pre-ECMO IMV duration of < 7 days (< 10 days) were compared to ≥ 7 days (≥ 10 days) (p = 0.59 and p = 1.0). Conclusions The role of prolonged pre-ECMO IMV duration as a contraindication for ECMO in patients with COVID-19-related ARDS should be scrutinised. Evaluation for ECMO should be assessed on an individual and patient-centred basis.

show abstract

ECMO Retrieval Program Foundation Financial Aspects and Negotiations with Manufactures

Elderia

Gaisendrees

Sindhu

et al. 2023

ECMO Retrieval Program Foundation

View full text Add to dashboard Cite

High In-Hospital Mortality Rate in Patients with COVID-19 Receiving Extracorporeal Membrane Oxygenation in Germany: A Critical Analysis

Cited by 52 publications

References 9 publications

Extracorporeal Membrane Oxygenation for COVID 2019-Acute Respiratory Distress Syndrome: Comparison between First and Second Waves (Stage 2)

Extracorporeal Membrane Oxygenation for COVID 2019-Acute Respiratory Distress Syndrome: Comparison between First and Second Waves (Stage 2)

Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019

ECMO Retrieval Program Foundation Financial Aspects and Negotiations with Manufactures

Contact Info

Product

Resources

About