Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia
Abstract Background Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives To describe the effect of ECMO rescue...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-021-00618-3 |
| _version_ | 1818701427494617088 |
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| author | Saad Alhumaid Abbas Al Mutair Header A. Alghazal Ali J. Alhaddad Hassan Al-Helal Sadiq A. Al Salman Jalal Alali Sana Almahmoud Zulfa M. Alhejy Ahmad A. Albagshi Javed Muhammad Amjad Khan Tarek Sulaiman Maha Al-Mozaini Kuldeep Dhama Jaffar A. Al-Tawfiq Ali A. Rabaan |
| author_facet | Saad Alhumaid Abbas Al Mutair Header A. Alghazal Ali J. Alhaddad Hassan Al-Helal Sadiq A. Al Salman Jalal Alali Sana Almahmoud Zulfa M. Alhejy Ahmad A. Albagshi Javed Muhammad Amjad Khan Tarek Sulaiman Maha Al-Mozaini Kuldeep Dhama Jaffar A. Al-Tawfiq Ali A. Rabaan |
| author_sort | Saad Alhumaid |
| collection | DOAJ |
| description | Abstract Background Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. Methods A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient’s medical records prospectively. Results ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). Conclusion Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations. |
| first_indexed | 2024-12-17T15:20:40Z |
| format | Article |
| id | doaj.art-92c8e7bc981f4c3a922b7e0bb990a328 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-17T15:20:40Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-92c8e7bc981f4c3a922b7e0bb990a3282022-12-21T21:43:25ZengBMCEuropean Journal of Medical Research2047-783X2021-12-0126112810.1186/s40001-021-00618-3Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi ArabiaSaad Alhumaid0Abbas Al Mutair1Header A. Alghazal2Ali J. Alhaddad3Hassan Al-Helal4Sadiq A. Al Salman5Jalal Alali6Sana Almahmoud7Zulfa M. Alhejy8Ahmad A. Albagshi9Javed Muhammad10Amjad Khan11Tarek Sulaiman12Maha Al-Mozaini13Kuldeep Dhama14Jaffar A. Al-Tawfiq15Ali A. Rabaan16Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of HealthResearch Center, Almoosa Specialist HospitalMicrobiology Laboratory, Prince Saud Bin Jalawi HospitalMicrobiology Department, Omran General HospitalDivision of Laboratory, Medical Microbiology Department, Maternity and Children HospitalDivision of Neurology, Internal Medicine Department, King Fahad Hofuf Hospital, Ministry of HealthInternal Medicine Department, King Fahad Hofuf Hospital, Ministry of HealthDepartment of Nursing Education, College of Nursing, Imam Abdulrahman Bin Faisal UniversityAdministration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of HealthAdministration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of HealthDepartment of Microbiology, The University of HaripurDepartment of Public Health/Nutrition, The University of HaripurInfectious Diseases Section, Medical Specialties Department, King Fahad Medical CityImmunocompromised Host Research Unit, Department of Infection and Immunity, King Faisal Specialist Hospital and Research CenterDivision of Pathology, ICAR-Indian Veterinary Research InstituteInfectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco HealthcareMolecular Diagnostics Laboratory, Johns Hopkins Aramco HealthcareAbstract Background Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. Methods A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient’s medical records prospectively. Results ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). Conclusion Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations.https://doi.org/10.1186/s40001-021-00618-3ClinicalCOVID-19ExtracorporealMembraneOxygenationECMO |
| spellingShingle | Saad Alhumaid Abbas Al Mutair Header A. Alghazal Ali J. Alhaddad Hassan Al-Helal Sadiq A. Al Salman Jalal Alali Sana Almahmoud Zulfa M. Alhejy Ahmad A. Albagshi Javed Muhammad Amjad Khan Tarek Sulaiman Maha Al-Mozaini Kuldeep Dhama Jaffar A. Al-Tawfiq Ali A. Rabaan Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia European Journal of Medical Research Clinical COVID-19 Extracorporeal Membrane Oxygenation ECMO |
| title | Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia |
| title_full | Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia |
| title_fullStr | Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia |
| title_full_unstemmed | Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia |
| title_short | Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia |
| title_sort | extracorporeal membrane oxygenation support for sars cov 2 a multi centered prospective observational study in critically ill 92 patients in saudi arabia |
| topic | Clinical COVID-19 Extracorporeal Membrane Oxygenation ECMO |
| url | https://doi.org/10.1186/s40001-021-00618-3 |
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