Universität zu Köln

Supady, Alexander ORCID: 0000-0003-4056-3652, Combes, Alain, Barbaro, Ryan P., Camporota, Luigi, Diaz, Rodrigo, Fan, Eddy, Giani, Marco ORCID: 0000-0001-8048-2721, Hodgson, Carol, Hough, Catherine L., Karagiannidis, Christian, Kochanek, Matthias, Rabie, Ahmed A., Riera, Jordi ORCID: 0000-0002-1738-4448, Slutsky, Arthur S. and Brodie, Daniel (2022). Respiratory indications for ECMO: focus on COVID-19. Intensive Care Med., 48 (10). S. 1326 - 1338. NEW YORK: SPRINGER. ISSN 1432-1238

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Abstract

Extracorporeal membrane oxygenation (ECMO) is increasingly being used for patients with severe respiratory failure and has received particular attention during the coronavirus disease 2019 (COVID-19) pandemic. Evidence from two key randomized controlled trials, a subsequent post hoc Bayesian analysis, and meta-analyses support the interpretation of a benefit of ECMO in combination with ultra-lung-protective ventilation for select patients with very severe forms of acute respiratory distress syndrome (ARDS). During the pandemic, new evidence has emerged helping to better define the role of ECMO for patients with COVID-19. Results from large cohorts suggest outcomes during the first wave of the pandemic were similar to those in non-COVID-19 cohorts. As the pandemic continued, mortality of patients supported with ECMO has increased. However, the precise reasons for this observation are unclear. Known risk factors for mortality in COVID-19 and non-COVID-19 patients are higher patient age, concomitant extra-pulmonary organ failures or malignancies, prolonged mechanical ventilation before ECMO, less experienced treatment teams and lower ECMO caseloads in the treating center. ECMO is a high resource-dependent support option; therefore, it should be used judiciously, and its availability may need to be constrained when resources are scarce. More evidence from high-quality research is required to better define the role and limitations of ECMO in patients with severe COVID-19.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Supady, Alexander UNSPECIFIED orcid.org/0000-0003-4056-3652 UNSPECIFIED Combes, Alain UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbaro, Ryan P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Camporota, Luigi UNSPECIFIED UNSPECIFIED UNSPECIFIED Diaz, Rodrigo UNSPECIFIED UNSPECIFIED UNSPECIFIED Fan, Eddy UNSPECIFIED UNSPECIFIED UNSPECIFIED Giani, Marco UNSPECIFIED orcid.org/0000-0001-8048-2721 UNSPECIFIED Hodgson, Carol UNSPECIFIED UNSPECIFIED UNSPECIFIED Hough, Catherine L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Karagiannidis, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Rabie, Ahmed A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Riera, Jordi UNSPECIFIED orcid.org/0000-0002-1738-4448 UNSPECIFIED Slutsky, Arthur S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brodie, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-698117
DOI:	10.1007/s00134-022-06815-w
Journal or Publication Title:	Intensive Care Med.
Volume:	48
Number:	10
Page Range:	S. 1326 - 1338
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1238
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTRACORPOREAL MEMBRANE-OXYGENATION; INVASIVE MECHANICAL VENTILATION; LIFE-SUPPORT; DISTRESS-SYNDROME; FAILURE; ARDS; MORTALITY; COHORT; ADULTS; 1ST Multiple languages Critical Care Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69811