Survival benefit of extracorporeal membrane oxygenation in severe COVID-19: a multi-centre-matched cohort study

被引：45

作者：

Whebell, Stephen ^{[1
,6
]}

Zhang, Joe ^{[2
,3
]}

Lewis, Rebecca ^{[1
]}

Berry, Michael ^{[2
]}

Ledot, Stephane ^{[4
]}

Retter, Andrew ^{[1
]}

Camporota, Luigi ^{[1
,5
]}

机构：

[1] Guys & St Thomas NHS Fdn Trust, Dept Adult Crit Care, London, England

[2] Kings Coll Hosp NHS Fdn Trust, Dept Crit Care, London, England

[3] Imperial Coll London, Inst Global Hlth Innovat, London, England

[4] Royal Brompton & Harefield NHS Fdn Trust, Dept Adult Intens Care, London, England

[5] Kings Coll London, Div Asthma Allergy & Lung Biol, London, England

[6] St Thomas Hosp, Dept Adult Crit Care, London SE1 7EH, England

来源：

INTENSIVE CARE MEDICINE | 2022年 / 48卷 / 04期

基金：

英国惠康基金;

关键词：

ECMO; COVID-19; ARDS; Severe respiratory failure; RESPIRATORY-DISTRESS-SYNDROME; SUPPORT; GUIDELINES; MORTALITY; CONSENSUS; ARDS;

D O I：

10.1007/s00134-022-06645-w

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose Extracorporeal membrane oxygenation (ECMO) has become an established therapy for severe respiratory failure in coronavirus disease 2019 (COVID-19). The added benefit of receiving ECMO in COVID-19 remains uncertain. The aim of this study is to analyse the impact of receiving ECMO at specialist centres on hospital mortality. Methods A multi-centre retrospective study was conducted in COVID-19 patients from 111 hospitals, referred to two specialist ECMO centres in the United Kingdom (UK) (March 2020 to February 2021). Detailed covariate data were contemporaneously curated from electronic referral systems. We analysed added benefit of ECMO treatment in specialist centres using propensity score matching techniques. Results 1363 patients, 243 receiving ECMO, were analysed. The best matching technique generated 209 matches, with a marginal odds ratio (OR) for mortality of 0.44 (95% CI 0.29-0.68, p < 0.001) and absolute mortality reduction of 18.2% (44% vs 25.8%, p < 0.001) for treatment with ECMO in a specialist centre. Conclusion We found ECMO provided at specialist centres conferred significant survival benefit. Where resources and specialism allow, ECMO should be widely offered.

引用

页码：467 / 478

页数：12

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