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:
CreatorsEmailORCIDORCID Put Code
Supady, AlexanderUNSPECIFIEDorcid.org/0000-0003-4056-3652UNSPECIFIED
Combes, AlainUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barbaro, Ryan P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Camporota, LuigiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diaz, RodrigoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fan, EddyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giani, MarcoUNSPECIFIEDorcid.org/0000-0001-8048-2721UNSPECIFIED
Hodgson, CarolUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hough, Catherine L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karagiannidis, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kochanek, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rabie, Ahmed A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riera, JordiUNSPECIFIEDorcid.org/0000-0002-1738-4448UNSPECIFIED
Slutsky, Arthur S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brodie, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
EXTRACORPOREAL MEMBRANE-OXYGENATION; INVASIVE MECHANICAL VENTILATION; LIFE-SUPPORT; DISTRESS-SYNDROME; FAILURE; ARDS; MORTALITY; COHORT; ADULTS; 1STMultiple languages
Critical Care MedicineMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69811

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