Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia
Severe COVID-19 pneumonia in which mechanical ventilation is unable to achieve adequate gas exchange can be treated with veno-venous ECMO, eliminating the need for aggressive mechanical ventilation which might promote ventilator-induced lung injury and increase mortality. In this retrospective obser...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/13/2203 |
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| author | Željka Drmić Ivan Bandić Sonja Hleb Andrea Kukoč Sanja Sakan Nataša Sojčić Darko Kristović Verica Mikecin Ivana Presečki Zrinka Šafarić Oremuš Nikola Bradić Jasminka Peršec Andrej Šribar |
| author_facet | Željka Drmić Ivan Bandić Sonja Hleb Andrea Kukoč Sanja Sakan Nataša Sojčić Darko Kristović Verica Mikecin Ivana Presečki Zrinka Šafarić Oremuš Nikola Bradić Jasminka Peršec Andrej Šribar |
| author_sort | Željka Drmić |
| collection | DOAJ |
| description | Severe COVID-19 pneumonia in which mechanical ventilation is unable to achieve adequate gas exchange can be treated with veno-venous ECMO, eliminating the need for aggressive mechanical ventilation which might promote ventilator-induced lung injury and increase mortality. In this retrospective observational study, 18 critically ill COVID-19 patients who were treated using V-V ECMO during an 11-month period in a tertiary COVID-19 hospital were analyzed. Biomarkers of inflammation and clinical features were compared between survivors and non-survivors. Survival rates were compared between patients receiving ECMO and propensity matched mechanically ventilated controls. There were 7 survivors and 11 non-survivors. The survivors were significantly younger, with a higher proportion of females, higher serum procalcitonin at ICU admission, and before initiation of ECMO they had significantly lower Murray scores, PaCO<sub>2</sub>, WBC counts, serum ferritin levels, and higher glomerular filtration rates. No significant difference in mortality was found between patients treated with ECMO compared to patients treated using conventional lung protective ventilation. Hypercapnia, leukocytosis, reduced glomerular filtration rate, and increased serum ferritin levels prior to initiation of V-V ECMO in patients with severe COVID-19 pneumonia may be early warning signs of reduced chance of survival. Further multicentric studies are needed to confirm these findings. |
| first_indexed | 2024-03-11T01:44:32Z |
| format | Article |
| id | doaj.art-c9237f55a27f4aaa8285f5c9cbb4edea |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T01:44:32Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-c9237f55a27f4aaa8285f5c9cbb4edea2023-11-18T16:21:27ZengMDPI AGDiagnostics2075-44182023-06-011313220310.3390/diagnostics13132203Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 PneumoniaŽeljka Drmić0Ivan Bandić1Sonja Hleb2Andrea Kukoč3Sanja Sakan4Nataša Sojčić5Darko Kristović6Verica Mikecin7Ivana Presečki8Zrinka Šafarić Oremuš9Nikola Bradić10Jasminka Peršec11Andrej Šribar12Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaClinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, CroatiaSevere COVID-19 pneumonia in which mechanical ventilation is unable to achieve adequate gas exchange can be treated with veno-venous ECMO, eliminating the need for aggressive mechanical ventilation which might promote ventilator-induced lung injury and increase mortality. In this retrospective observational study, 18 critically ill COVID-19 patients who were treated using V-V ECMO during an 11-month period in a tertiary COVID-19 hospital were analyzed. Biomarkers of inflammation and clinical features were compared between survivors and non-survivors. Survival rates were compared between patients receiving ECMO and propensity matched mechanically ventilated controls. There were 7 survivors and 11 non-survivors. The survivors were significantly younger, with a higher proportion of females, higher serum procalcitonin at ICU admission, and before initiation of ECMO they had significantly lower Murray scores, PaCO<sub>2</sub>, WBC counts, serum ferritin levels, and higher glomerular filtration rates. No significant difference in mortality was found between patients treated with ECMO compared to patients treated using conventional lung protective ventilation. Hypercapnia, leukocytosis, reduced glomerular filtration rate, and increased serum ferritin levels prior to initiation of V-V ECMO in patients with severe COVID-19 pneumonia may be early warning signs of reduced chance of survival. Further multicentric studies are needed to confirm these findings.https://www.mdpi.com/2075-4418/13/13/2203COVID-19ECMOsurvival analysismechanical ventilationbiomarkers |
| spellingShingle | Željka Drmić Ivan Bandić Sonja Hleb Andrea Kukoč Sanja Sakan Nataša Sojčić Darko Kristović Verica Mikecin Ivana Presečki Zrinka Šafarić Oremuš Nikola Bradić Jasminka Peršec Andrej Šribar Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia Diagnostics COVID-19 ECMO survival analysis mechanical ventilation biomarkers |
| title | Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia |
| title_full | Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia |
| title_fullStr | Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia |
| title_full_unstemmed | Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia |
| title_short | Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia |
| title_sort | inflammatory biomarkers affecting survival prognosis in patients receiving veno venous ecmo for severe covid 19 pneumonia |
| topic | COVID-19 ECMO survival analysis mechanical ventilation biomarkers |
| url | https://www.mdpi.com/2075-4418/13/13/2203 |
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