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Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19

Shaefi, Shahzad ; Brenner, Samantha K. ; Gupta, Shruti ; O’Gara, Brian P. ; Krajewski, Megan L. ; Charytan, David M. ; Chaudhry, Sobaata ; Mirza, Sara H. ; Peev, Vasil ; Anderson, Mark ; Bansal, Anip ; Hayek, Salim S. ; Srivastava, Anand ; Mathews, Kusum S. ; Johns, Tanya S. ; Leonberg-Yoo, Amanda ; Green, Adam ; Arunthamakun, Justin ; Wille, Keith M. ; Shaukat, Tanveer ; Singh, Harkarandeep ; Admon, Andrew J. ; Semler, Matthew W. ; Hernán, Miguel A. ; Mueller, Ariel L. ; Wang, Wei ; Leaf, David E.

Intensive care medicine, 2021-02, Vol.47 (2), p.208-221 [Periódico revisado por pares]

Berlin/Heidelberg: Springer Berlin Heidelberg

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Título:
Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19
Autor: Shaefi, Shahzad ; Brenner, Samantha K. ; Gupta, Shruti ; O’Gara, Brian P. ; Krajewski, Megan L. ; Charytan, David M. ; Chaudhry, Sobaata ; Mirza, Sara H. ; Peev, Vasil ; Anderson, Mark ; Bansal, Anip ; Hayek, Salim S. ; Srivastava, Anand ; Mathews, Kusum S. ; Johns, Tanya S. ; Leonberg-Yoo, Amanda ; Green, Adam ; Arunthamakun, Justin ; Wille, Keith M. ; Shaukat, Tanveer ; Singh, Harkarandeep ; Admon, Andrew J. ; Semler, Matthew W. ; Hernán, Miguel A. ; Mueller, Ariel L. ; Wang, Wei ; Leaf, David E.
Assuntos: Adult ; Analysis ; Anesthesiology ; Care and treatment ; Cohort Studies ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - therapy ; Critical Care Medicine ; Emergency Medicine ; Extracorporeal Membrane Oxygenation ; Failure ; Female ; Health aspects ; Humans ; Hypoxemia ; Intensive ; Intensive care ; Male ; Medicine ; Medicine & Public Health ; Membranes ; Middle Aged ; Mortality ; Original ; Oxygenation ; Pain Medicine ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Respiratory Distress Syndrome - therapy ; Respiratory Distress Syndrome - virology ; Respiratory insufficiency ; Secondary analysis ; Treatment Outcome ; United Kingdom ; Ventilation ; Viral diseases
É parte de: Intensive care medicine, 2021-02, Vol.47 (2), p.208-221
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SourceType-Scholarly Journals-1
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Descrição: Purpose Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19). Methods We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU admission, using data from a multicenter cohort study of 5122 critically ill adults with COVID-19 admitted to 68 hospitals across the United States. To estimate the effect of ECMO on mortality, we emulated a target trial of ECMO receipt versus no ECMO receipt within 7 days of ICU admission among mechanically ventilated patients with severe hypoxemia (PaO 2 /FiO 2 < 100). Patients were followed until hospital discharge, death, or a minimum of 60 days. We adjusted for confounding using a multivariable Cox model. Results Among the 190 patients treated with ECMO, the median age was 49 years (IQR 41–58), 137 (72.1%) were men, and the median PaO 2 /FiO 2 prior to ECMO initiation was 72 (IQR 61–90). At 60 days, 63 patients (33.2%) had died, 94 (49.5%) were discharged, and 33 (17.4%) remained hospitalized. Among the 1297 patients eligible for the target trial emulation, 45 of the 130 (34.6%) who received ECMO died, and 553 of the 1167 (47.4%) who did not receive ECMO died. In the primary analysis, patients who received ECMO had lower mortality than those who did not (HR 0.55; 95% CI 0.41–0.74). Results were similar in a secondary analysis limited to patients with PaO 2 /FiO 2 < 80 (HR 0.55; 95% CI 0.40–0.77). Conclusion In select patients with severe respiratory failure from COVID-19, ECMO may reduce mortality.
Editor: Berlin/Heidelberg: Springer Berlin Heidelberg
Idioma: Inglês

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Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19

Berlin/Heidelberg: Springer Berlin Heidelberg

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