ECMO is associated with decreased hospital mortality in COVID-19 ARDSopen access
- Authors
- Kim, Won-Young; Jung, Sun-Young; Kim, Jeong-Yeon; Chae, Ganghee; Kim, Junghyun; Joh, Joon-Sung; Park, Tae Yun; Baek, Ae-Rin; Jegal, Yangjin; Chung, Chi Ryang; Lee, Jinwoo; Cho, Young-Jae; Park, Joo Hun; Hwang, Jung Hwa; Song, Jin Woo
- Issue Date
- Jun-2024
- Publisher
- NATURE PORTFOLIO
- Citation
- Scientific reports, v.14, no.1
- Journal Title
- Scientific reports
- Volume
- 14
- Number
- 1
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/75158
- DOI
- 10.1038/s41598-024-64949-x
- ISSN
- 2045-2322
2045-2322
- Abstract
- This study determined whether compared to conventional mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO) is associated with decreased hospital mortality or fibrotic changes in patients with COVID-19 acute respiratory distress syndrome. A cohort of 72 patients treated with ECMO and 390 with conventional MV were analyzed (February 2020-December 2021). A target trial was emulated comparing the treatment strategies of initiating ECMO vs no ECMO within 7 days of MV in patients with a PaO2/FiO2 < 80 or a PaCO2 ≥ 60 mmHg. A total of 222 patients met the eligibility criteria for the emulated trial, among whom 42 initiated ECMO. ECMO was associated with a lower risk of hospital mortality (hazard ratio [HR], 0.56; 95% confidence interval [CI] 0.36-0.96). The risk was lower in patients who were younger (age < 70 years), had less comorbidities (Charlson comorbidity index < 2), underwent prone positioning before ECMO, and had driving pressures ≥ 15 cmH2O at inclusion. Furthermore, ECMO was associated with a lower risk of fibrotic changes (HR, 0.30; 95% CI 0.11-0.70). However, the finding was limited due to relatively small number of patients and differences in observability between the ECMO and conventional MV groups. © 2024. The Author(s).
- Files in This Item
-
- Appears in
Collections - ETC > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.