Abstract
Background: The data on long-term outcomes of patients infected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available.Methods: A retrospective study included 73 patients infected by SARS-CoV-2 and treated with ECMO in 21 intensive care units in Hubei, China. Data on demographic information, clinical features, laboratory tests, ECMO durations, complications, and living status were collected.Results: The 73 ECMO-treated patients had a median age of 62 (range 33–78) years and 42 (63.6%) were males. Before ECMO initiation, patients had severe respiratory failure on mechanical ventilation with a median PO2/FiO2 of 71.9 [interquartile range (IQR), 58.6–87.0] mmHg and a median PCO2 of 62 [IQR, 43–84] mmHg on arterial blood analyses. The median duration from symptom onset to invasive mechanical ventilation, and to ECMO initiation was19 [IQR, 15–25] days, and 23 [IQR, 19–31] days. Before and after ECMO initiation, the proportions of patients receiving prone position ventilation were 58.9 and 69.9%, respectively. The median duration of ECMO support was 18.5 [IQR 12–30] days. During the treatments with ECMO, major hemorrhages occurred in 31 (42.5%) patients, and oxygenators were replaced in 21 (28.8%) patients. Since ECMO initiation, the 30-day mortality and 60-day mortality were 63.0 and 80.8%, respectively.Conclusions: In Hubei, China, the ECMO-treated patients infected by SARS-CoV-2 were of a broad age range and with severe hypoxemia. The durations of ECMO support, accompanied with increased complications, were relatively long. The long-term mortality in these patients was considerably high.
Highlights
The data on long-term outcomes of patients infected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available
Twenty-one intensive care units (ICUs) that provided ECMO support to adult acute respiratory distress syndrome (ARDS) patients with COVID-19 during the study period contributed to this study
The median duration of ECMO therapy was [interquartile range (IQR) 11–29] days, with no significant difference between those successfully and unsuccessfully weaned off ECMO [median (IQR), 17.5 [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35] in patients and 17 [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27] in 53 patients]. This multicenter study on the use of ECMO for patients with ARDS caused by SARS-CoV-2 showed that patients of a broad age range were treated with ECMO in Hubei, China, for a relatively long duration and the mortality of these patients were considerably high
Summary
The data on long-term outcomes of patients infected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available. The Chinese government took aggressive measures, including the lockdown of all cities in Hubei Province, and succeeded in stopping the spread of the virus in mainland China [6, 7]. Based on the WHO interim guidance, extracorporeal membrane oxygenation (ECMO) was recommended to treat patients with refractory hypoxemia, hypercapnia, or both [13]. Chinese critical care physicians have been utilizing since the beginning of SARS-CoV-2 epidemic in Wuhan City, and later in other cities of Hubei Province. The characteristics, severity of respiratory failure, duration of ECMO, complications, and long-term outcomes of patients with severe ARDS caused with SARSCoV-2 treated with ECMO in Hubei, China are far beyond knowledge [15]
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