Worldwide application and valuation of extracorporeal membrane oxygenation support during the COVID-19 pandemic (WAVES)-Reference-Cited by-同舟云学术

Worldwide application and valuation of extracorporeal membrane oxygenation support during the COVID-19 pandemic (WAVES)

Published:2024-07-24 Issue: Volume: Page:
ISSN:0267-6591
Container-title:Perfusion
language:en
Short-container-title:Perfusion

Author:

Zaaqoq Akram M¹^ORCID,Heinsar Silver²³,Yoon Hwan-Jin⁴⁵,White Nicole²⁴,Griffee Matthew J⁶,Suen Jacky Y²,Bassi Gianluigi L²⁷,Fanning Jonathon P²,Shehatta Ahmad Labib⁸,Alexander Peta M.A.⁹,Jacobs Jeffrey P.¹⁰,Dalton Heidi J¹¹,Lorusso Roberto¹²^ORCID,Cho Sung-Min¹³¹⁴,Peek Giles J¹⁰^ORCID,Fraser John F²,

Affiliation:

1. Department of Anesthesiology, Division of Critical Care, University of Virginia, Charlottesville, VA, USA

2. Critical Care Research Group, University of Queensland and Adult Intensive Care Service, Prince Charles Hospital Brisbane, QLD, Australia

3. Department of Intensive Care, North Estonia Medical Centre, Tallinn, Estonia

4. School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia

5. Australian e-Health Research Centre, CSIRO Health & Biosecurity, Australia

6. Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA

7. Institut D'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain

8. Medical Intensive Care Unit, Hamad General Hospital, Weill Cornell Medicine, Doha, Qatar

9. Department of Cardiology, Boston Children’s Hospital; Department of Pediatrics, Harvard Medical School, Boston, MA

10. Congenital Heart Center, Division of Cardiovascular Surgery, University of Florida, Gainesville, FL, USA

11. Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, USA

12. Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands

13. Department of Surgery, Division of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.

14. Departments of Neurology, Anesthesiology, Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Abstract

Objective The outcomes of COVID-19 patients on venovenous extracorporeal membrane oxygenation (VV-ECMO) varied. We aim to investigate the variability concerning location and timeframe. We conducted a retrospective analysis of data from 351 institutions in 53 countries. The primary outcome was survival to hospital discharge or death up to 90 days from ECMO start. The associations between calendar time (month and year) of ECMO initiation and the primary outcome were examined by Cox regression modeling. Multivariable survival analyses were adjusted for the time of ECMO start, age, body mass index, APACHE II, SOFA, and the duration of mechanical ventilation before ECMO. Results 1060 adult COVID-19 patients enrolled in the COVID-19 Critical Care Consortium (COVID Critical) international registry and required VV-ECMO support. The study period is from January 2020 to December 2021. The median age was 51 years old, and 70% were male patients. Most patients were from Europe (39.3%) and North America (37.4%). The in-hospital mortality of the entire cohort was 47.12%. In North America and Europe, there was an increased probability of death from May 2020 through February 2021. Latin America showed a steady rate of survival until late in the study. South Asia, the Middle East, and Africa showed an increased chance of mortality around May 2020. In the Asian-Pacific region, after February 2021, there was an increased probability of death. The time of ECMO initiation and advanced patient age were associated with increased mortality. Conclusion Variability in the outcomes of COVID-19 patients on VV-ECMO existed within different regions. This variability reflects the differences in resources, policies, patient selection, management, and possibly COVID-19 virus subtypes. Our findings might help guide global response in the future by early adoption of patient selection protocols, worldwide policies, and delivery of resources.

Funder

Bill and Melinda Gates Foundation

The University of Queensland

The Wesley Medical Research

The Prince Charles Hospital Foundation

The Health Research Board of Ireland

Publisher

SAGE Publications

Link

https://journals.sagepub.com/doi/pdf/10.1177/02676591241267228

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