TY  - JOUR
A1  - Friedrichson, Benjamin
A1  - Kloka, Jan Andreas
A1  - Neef, Vanessa
A1  - Mutlak, Haitham
A1  - Old, Oliver
A1  - Zacharowski, Kai
A1  - Piekarski, Florian
T1  - Extracorporeal membrane oxygenation in coronavirus disease 2019 : A nationwide cohort analysis of 4279 runs from Germany
T2  - European journal of anaesthesiology
N2  - BACKGROUND: In the context of the coronavirus disease 2019 (COVID-19) pandemic, many retrospective single-centre or specialised centre reports have shown promising mortality rates with the use of extracorporeal membrane oxygenation (ECMO) therapy. However, the mortality rate of an entire country throughout the COVID-19 pandemic remains unknown.
OBJECTIVES: The primary objective is to determine the hospital mortality in COVID-19 patients receiving venovenous ECMO (VV-ECMO) and veno-arterial ECMO (VA-ECMO) therapy. Secondary objectives are the chronological development of mortality during the pandemic, the analysis of comorbidities, age and complications.
DESIGN: Cohort study.
SETTING: Inpatient data from January 2020 to September 2021 of all hospitals in Germany were analysed.
PARTICIPANTS: All COVID-19-positive patients who received ECMO therapy were analysed according to the appropriate international statistical classification of diseases and related health problem codes (ICDs) and process key codes (OPSs).
MAIN OUTCOME MEASURES: The primary outcome was the hospital mortality.
RESULTS: In total, 4279 COVID-19-positive patients who received ECMO therapy were analysed. Among 404 patients treated with VA-ECMO and 3875 treated with VV-ECMO, the hospital mortality was high: 72% (n = 291) for VA-ECMO and 65.9% (n = 2552) for VV-ECMO. A total of 43.2% (n = 1848) of all patients were older than 60 years with a hospital mortality rate of 72.7% (n = 172) for VA-ECMO and 77.6% (n = 1301) for VV-ECMO. CPR was performed in 44.1% (n = 178) of patients with VA-ECMO and 16.4% (n = 637) of patients with VV-ECMO. The mortality rates widely varied from 48.1 to 84.4% in individual months and worsened from March 2020 (59.2%) to September 2021 (78.4%).
CONCLUSION: In Germany, a large proportion of elderly patients with COVID-19 were treated with ECMO, with an unacceptably high hospital mortality. Considering these data, the unconditional use of ECMO therapy in COVID-19 must be carefully considered and advanced age should be considered as a relative contraindication.
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/84436
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-844362
SN  - 1365-2346
N1  - Financial support and sponsorship: this study was supported by internal institutional research funds from the Department of Anaes-thesiology, Intensive Care and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt Germany.
VL  - 39
IS  - 5
SP  - 445
EP  - 451
PB  - Lippincott Williams & Wilkins ; Ovid ; Wolters Kluwer Health
CY  - Philadelphia, Pa ; New York, NY ; Riverwoods, Ill.
ER  -