Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/38829
Title: Predictors of poor outcome in critically ill patients with COVID-19 pneumonia treated with extracorporeal membrane oxygenation
Authors: Pans, Nick
Vanherf, Jul
VANDENBRANDE, Jeroen 
Lehaen, Jeroen
Yilmaz, Alaaddin
VERWERFT, Jan 
Van Tornout, Michiel
Geebelen, Laurien
CALLEBAUT, Ina 
HERBOTS, Lieven 
Dubois, Jasperina
STESSEL, Bjorn 
Issue Date: 2022
Publisher: SAGE PUBLICATIONS LTD
Source: PERFUSION-UK,
Status: Early view
Abstract: Introduction We aimed to identify risk factors associated with ICU mortality in critically ill patients with COVID-19 pneumonia treated with Extracorporeal membrane oxygenation (ECMO). We also aimed to assess protocol violations of the local eligibility criteria of ECMO initiation. Methods All 31 consecutive adult patients with confirmed COVID-19 pneumonia admitted to ICU and treated with ECMO from March 13th 2020 to 8 December 2021 were enrolled. Eligibility criteria for ECMO initiation were: P/F-ratio3 hours, P/F-ratio6 hours or pH60 mmHg >6 hours, despite maximal protective invasive ventilation. Primary outcome was ICU mortality. Univariate logistic regression analyses were performed to identify predictors of ICU mortality. Results 12 out of 31 patients (38.7%) did not survive ECMO treatment in ICU. Half of the non-survivors suffered from acute kidney failure compared to 3 out of 19 survivors (15.79%) (p = .04). Half of the non-survivors required CRRT treatment versus 1 patient in the survivor group (5.3%) (p < .01). Higher age (2.45 (0.97-6.18), p = .05), the development of AKI (5.33 (1.00-28.43), p = .05), need of CRRT during ICU stay (18.00 (1.79-181.31), p = .01) and major bleeding during ECMO therapy (0.51 (0.19-0.89), p < .01) were identified to be predictors of ICU mortality. Conclusion Almost 60% of patients could be treated successfully with ECMO with sustained results at 3 months. Predictors for ICU mortality were development of AKI and need of CRRT during ICU stay, higher age category and major bleeding. Inadvertent ECMO allocation was noted in almost one in five patients.
Notes: Stessel, B (corresponding author), Jessa Hosp Hasselt, Dept Intens Care & Anesthesiol, Virga Jesse Campus,Stadsomvaart 11, B-3500 Hasselt, Belgium.
bjorn.stessel@jessazh.be
Keywords: COVID-19;COVID-19;extracorporeal membrane oxygenation;extracorporeal membrane oxygenation;intensive care unit;intensive care unit;predictor;predictor;mortality;mortality
Document URI: http://hdl.handle.net/1942/38829
ISSN: 0267-6591
e-ISSN: 1477-111X
DOI: 10.1177/02676591221131487
ISI #: 000866198500001
Rights: The Author(s) 2022
Category: A1
Type: Journal Contribution
Validations: ecoom 2023
Appears in Collections:Research publications

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