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Hermann M, Laxar D, Krall C, et al. Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019. Ann Intensive Care. 2022;12(1):6doi: 10.1186/s13613-022-00980-3.
Hermann, M., Laxar, D., Krall, C., Hafner, C., Herzog, O., Kimberger, O., Koenig, S., Kraft, F., Maleczek, M., Markstaller, K., Robak, O., Rössler, B., Schaden, E., Schellongowski, P., Schneeweiss-Gleixner, M., Staudinger, T., Ullrich, R., Wiegele, M., Willschke, H., Zauner, C., & Hermann, A. (2022). Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019. Annals of intensive care, 12(1), 6. https://doi.org/10.1186/s13613-022-00980-3
Hermann, Martina, et al. "Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019." Annals of intensive care vol. 12,1 (2022): 6. doi: https://doi.org/10.1186/s13613-022-00980-3
Hermann M, Laxar D, Krall C, Hafner C, Herzog O, Kimberger O, Koenig S, Kraft F, Maleczek M, Markstaller K, Robak O, Rössler B, Schaden E, Schellongowski P, Schneeweiss-Gleixner M, Staudinger T, Ullrich R, Wiegele M, Willschke H, Zauner C, Hermann A. Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019. Ann Intensive Care. 2022 Jan 13;12(1):6. doi: 10.1186/s13613-022-00980-3. PMID: 35024972.
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Ann Intensive Care. 2022 Jan 13;12(1):6. doi: 10.1186/s13613-022-00980-3.

Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019.

Annals of intensive care

Martina Hermann, Daniel Laxar, Christoph Krall, Christina Hafner, Oliver Herzog, Oliver Kimberger, Sebastian Koenig, Felix Kraft, Mathias Maleczek, Klaus Markstaller, Oliver Robak, Bernhard Rössler, Eva Schaden, Peter Schellongowski, Mathias Schneeweiss-Gleixner, Thomas Staudinger, Roman Ullrich, Marion Wiegele, Harald Willschke, Christian Zauner, Alexander Hermann

Affiliations

  1. Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  2. Ludwig Boltzmann Institute for Digital Health and Patient Safety, Spitalgasse 23, BT86, 1090, Vienna, Austria.
  3. Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, BT88, 1090, Vienna, Austria.
  4. Department of Medicine I, Medical University of Vienna, Intensive Care Unit 13i2, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  5. Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  6. Department of Medicine I, Medical University of Vienna, Intensive Care Unit 13i2, Waehringer Guertel 18-20, 1090, Vienna, Austria. [email protected].

PMID: 35024972 DOI: 10.1186/s13613-022-00980-3

Abstract

BACKGROUND: Duration of invasive mechanical ventilation (IMV) prior to extracorporeal membrane oxygenation (ECMO) affects outcome in acute respiratory distress syndrome (ARDS). In coronavirus disease 2019 (COVID-19) related ARDS, the role of pre-ECMO IMV duration is unclear. This single-centre, retrospective study included critically ill adults treated with ECMO due to severe COVID-19-related ARDS between 01/2020 and 05/2021. The primary objective was to determine whether duration of IMV prior to ECMO cannulation influenced ICU mortality.

RESULTS: During the study period, 101 patients (mean age 56 [SD ± 10] years; 70 [69%] men; median RESP score 2 [IQR 1-4]) were treated with ECMO for COVID-19. Sixty patients (59%) survived to ICU discharge. Median ICU length of stay was 31 [IQR 20.7-51] days, median ECMO duration was 16.4 [IQR 8.7-27.7] days, and median time from intubation to ECMO start was 7.7 [IQR 3.6-12.5] days. Fifty-three (52%) patients had a pre-ECMO IMV duration of > 7 days. Pre-ECMO IMV duration had no effect on survival (p = 0.95). No significant difference in survival was found when patients with a pre-ECMO IMV duration of < 7 days (< 10 days) were compared to ≥ 7 days (≥ 10 days) (p = 0.59 and p = 1.0).

CONCLUSIONS: The role of prolonged pre-ECMO IMV duration as a contraindication for ECMO in patients with COVID-19-related ARDS should be scrutinised. Evaluation for ECMO should be assessed on an individual and patient-centred basis.

© 2022. The Author(s).

Keywords: Acute respiratory distress syndrome; COVID-19; Extracorporeal membrane oxygenation; Invasive mechanical ventilation

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