Extracorporeal membrane oxygenation in COVID-19: Results of the Croatian Extracorporeal Membrane Oxygenation Referral Center

Scientific paper - Original scientific paper

• Author: Marko Kutleša
• Author: Marija Santini
• Author: Vladimir Krajinović
• Author: Neven Papić
• Author: Branimir Gjurašin
• Author: Juraj Krznarić
• Author: Viktor Kotarski
• Author's institution: University of Zagreb; School of Medicine; (Department of Infectious Diseases)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract (english)

At the beginning of the COVID-19 pandemic, the role of extracorporeal membrane oxygenation (ECMO) was uncertain and the outcomes of ECMO-treated patients were unfavorable. During the pandemic, medical community realized that carefully selected patients may benefit from ECMO support. The goal of the study was to present the outcomes of ECMO-treated patients with severe COVID-19 ARDS referred to the respiratory ECMO hub in Croatia and to determine variables that influenced the outcome. Our study included all adult patients with confirmed COVID-19 ARDS that required ECMO treatment, in the period between February 2020 and April 2022. All ECMO circuits were veno-venous with femoro-jugular configuration, with drainage at the femoral site. A total of 112 adult patients with COVID-19 induced ARDS were included in the study. All patients had veno-venous ECMO treatment and 34 survived. Surviving patients were discharged home either from the hospital or from a designated rehabilitation facility. The mortality was associated with the incidence of nosocomial bacteremia, occurrence of heparin induced thrombocytopenia and acute renal failure. In order to reduce the mortality in COVID-19 ECMO patients, the treatment should be started as soon as criteria for ECMO are met. Furthermore, complications of the procedure should be detected as soon as possible. However, despite even the optimal approach, the mortality in COVID-19 ECMO patients will surpass that of non-COVID-19 ARDS ECMO patients, mostly due to poor resolving and long lasting ARDS with longer ECMO runs and ensuing infectious complications.

• Keywords (english): Adult; COVID-19 / therapy; Croatia / epidemiology; Extracorporeal Membrane Oxygenation / adverse effects; Extracorporeal Membrane Oxygenation / methods; Humans; Pandemics; Referral and Consultation; Respiratory Distress Syndrome / etiology; Respiratory Distress Syndrome / therapy
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: The International Journal of Artificial Organs
• Numbering: vol. 46, no. 4, pp. 248-251
• p-ISSN: 0391-3988
• e-ISSN: 1724-6040
• DOI: https://doi.org/10.1177/03913988231163891
• URN:NBN: urn:nbn:hr:105:607587
• Publication: 2023-03-24
• Document URL: http://journals.sagepub.com/doi/10.1177/03913988231163891
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-01-09 08:49:41