The effect of therapeutic plasma exchange therapy on veno-venous ECMO weaning success in severe COVID-19 ARDS patients

Introduction Primarily, this study aimed to investigate the effect of TPE (therapeutic plasma exchange) treatment on successful ECMO weaning in severe COVID-19 ARDS patients treated with V-V ECMO.Methods The study was applied retrospectively on patients over the age of 18 who were hospitalized in the ICU between January 1, 2020 and March 1, 2022.Results The study was performed on 33 patients, 36.3% (n: 12) of whom received TPE treatment. The rate of successful ECMO weaning was statistically higher in the TPE treatment group (without TPE: 14.3% [n: 3], with TPE: 50% [n: 6], p = 0.044). The 1-month mortality was also statistically lower in the TPE treatment group (p = 0.044). In the logistic analysis, It was found that the risk of unsuccessful ECMO weaning increased 6 times in those who did not receive TPE treatment (OR; 6.0, 95% CI; 1.134-31.735, p = 0.035).Conclusion TPE treatment may increase the success rate of V-V ECMO weaning in severe COVID-19 ARDS patients treated with V-V ECMO.