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Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation

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Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation. / Herrmann, Johannes; Lotz, Christopher; Karagiannidis, Christian; Weber-Carstens, Steffen; Kluge, Stefan; Putensen, Christian; Wehrfritz, Andreas; Schmidt, Karsten; Ellerkmann, Richard K; Oswald, Daniel; Lotz, Gösta; Zotzmann, Viviane; Moerer, Onnen; Kühn, Christian; Kochanek, Matthias; Muellenbach, Ralf; Gaertner, Matthias; Fichtner, Falk; Brettner, Florian; Findeisen, Michael; Heim, Markus; Lahmer, Tobias; Rosenow, Felix; Haake, Nils; Lepper, Philipp M; Rosenberger, Peter; Braune, Stephan; Kohls, Mirjam; Heuschmann, Peter; Meybohm, Patrick; German ECMO COVID Study Group.

in: CRIT CARE, Jahrgang 26, Nr. 1, 190, 28.06.2022.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Herrmann, J, Lotz, C, Karagiannidis, C, Weber-Carstens, S, Kluge, S, Putensen, C, Wehrfritz, A, Schmidt, K, Ellerkmann, RK, Oswald, D, Lotz, G, Zotzmann, V, Moerer, O, Kühn, C, Kochanek, M, Muellenbach, R, Gaertner, M, Fichtner, F, Brettner, F, Findeisen, M, Heim, M, Lahmer, T, Rosenow, F, Haake, N, Lepper, PM, Rosenberger, P, Braune, S, Kohls, M, Heuschmann, P, Meybohm, P & German ECMO COVID Study Group 2022, 'Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation', CRIT CARE, Jg. 26, Nr. 1, 190. https://doi.org/10.1186/s13054-022-04053-6

APA

Herrmann, J., Lotz, C., Karagiannidis, C., Weber-Carstens, S., Kluge, S., Putensen, C., Wehrfritz, A., Schmidt, K., Ellerkmann, R. K., Oswald, D., Lotz, G., Zotzmann, V., Moerer, O., Kühn, C., Kochanek, M., Muellenbach, R., Gaertner, M., Fichtner, F., Brettner, F., ... German ECMO COVID Study Group (2022). Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation. CRIT CARE, 26(1), [190]. https://doi.org/10.1186/s13054-022-04053-6

Vancouver

Herrmann J, Lotz C, Karagiannidis C, Weber-Carstens S, Kluge S, Putensen C et al. Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation. CRIT CARE. 2022 Jun 28;26(1). 190. https://doi.org/10.1186/s13054-022-04053-6

Bibtex

@article{0ba39cb4ce824d569a2dbf5a8c6ca85a,
title = "Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation",
abstract = "BACKGROUND: Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients.METHODS: 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival.RESULTS: Most patients were between 50 and 70 years of age. PaO2/FiO2 ratio prior to ECMO was 72 mmHg (IQR: 58-99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41-0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28-1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events.CONCLUSIONS: Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.TRIAL REGISTRATION: Registered in the German Clinical Trials Register (study ID: DRKS00022964, retrospectively registered, September 7th 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022964 .",
keywords = "COVID-19/therapy, Extracorporeal Membrane Oxygenation, Humans, Intensive Care Units, Pandemics, Respiratory Distress Syndrome/therapy",
author = "Johannes Herrmann and Christopher Lotz and Christian Karagiannidis and Steffen Weber-Carstens and Stefan Kluge and Christian Putensen and Andreas Wehrfritz and Karsten Schmidt and Ellerkmann, {Richard K} and Daniel Oswald and G{\"o}sta Lotz and Viviane Zotzmann and Onnen Moerer and Christian K{\"u}hn and Matthias Kochanek and Ralf Muellenbach and Matthias Gaertner and Falk Fichtner and Florian Brettner and Michael Findeisen and Markus Heim and Tobias Lahmer and Felix Rosenow and Nils Haake and Lepper, {Philipp M} and Peter Rosenberger and Stephan Braune and Mirjam Kohls and Peter Heuschmann and Patrick Meybohm and {German ECMO COVID Study Group} and Dominik Jarczak and Kevin Roedl",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = jun,
day = "28",
doi = "10.1186/s13054-022-04053-6",
language = "English",
volume = "26",
journal = "CRIT CARE",
issn = "1364-8535",
publisher = "Springer Science + Business Media",
number = "1",

}

RIS

TY - JOUR

T1 - Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation

AU - Herrmann, Johannes

AU - Lotz, Christopher

AU - Karagiannidis, Christian

AU - Weber-Carstens, Steffen

AU - Kluge, Stefan

AU - Putensen, Christian

AU - Wehrfritz, Andreas

AU - Schmidt, Karsten

AU - Ellerkmann, Richard K

AU - Oswald, Daniel

AU - Lotz, Gösta

AU - Zotzmann, Viviane

AU - Moerer, Onnen

AU - Kühn, Christian

AU - Kochanek, Matthias

AU - Muellenbach, Ralf

AU - Gaertner, Matthias

AU - Fichtner, Falk

AU - Brettner, Florian

AU - Findeisen, Michael

AU - Heim, Markus

AU - Lahmer, Tobias

AU - Rosenow, Felix

AU - Haake, Nils

AU - Lepper, Philipp M

AU - Rosenberger, Peter

AU - Braune, Stephan

AU - Kohls, Mirjam

AU - Heuschmann, Peter

AU - Meybohm, Patrick

AU - German ECMO COVID Study Group

AU - Jarczak, Dominik

AU - Roedl, Kevin

N1 - © 2022. The Author(s).

PY - 2022/6/28

Y1 - 2022/6/28

N2 - BACKGROUND: Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients.METHODS: 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival.RESULTS: Most patients were between 50 and 70 years of age. PaO2/FiO2 ratio prior to ECMO was 72 mmHg (IQR: 58-99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41-0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28-1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events.CONCLUSIONS: Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.TRIAL REGISTRATION: Registered in the German Clinical Trials Register (study ID: DRKS00022964, retrospectively registered, September 7th 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022964 .

AB - BACKGROUND: Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients.METHODS: 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival.RESULTS: Most patients were between 50 and 70 years of age. PaO2/FiO2 ratio prior to ECMO was 72 mmHg (IQR: 58-99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41-0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28-1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events.CONCLUSIONS: Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.TRIAL REGISTRATION: Registered in the German Clinical Trials Register (study ID: DRKS00022964, retrospectively registered, September 7th 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022964 .

KW - COVID-19/therapy

KW - Extracorporeal Membrane Oxygenation

KW - Humans

KW - Intensive Care Units

KW - Pandemics

KW - Respiratory Distress Syndrome/therapy

U2 - 10.1186/s13054-022-04053-6

DO - 10.1186/s13054-022-04053-6

M3 - SCORING: Journal article

C2 - 35765102

VL - 26

JO - CRIT CARE

JF - CRIT CARE

SN - 1364-8535

IS - 1

M1 - 190

ER -