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Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study

The role of veno-venous extracorporeal membrane oxygenation therapy (V-V ECMO) in severe COVID-19 acute respiratory distress syndrome (ARDS) is still under debate and conclusive data from large cohorts are scarce. Furthermore, criteria for the selection of patients that benefit most from this highly...

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Autores principales: Supady, Alexander, DellaVolpe, Jeff, Taccone, Fabio Silvio, Scharpf, Dominik, Ulmer, Matthias, Lepper, Philipp M., Halbe, Maximilian, Ziegeler, Stephan, Vogt, Alexander, Ramanan, Raj, Boldt, David, Stecher, Stephanie-Susanne, Montisci, Andrea, Spangenberg, Tobias, Marggraf, Olivier, Kunavarapu, Chandra, Peluso, Lorenzo, Muenz, Sebastian, Buerle, Monica, Nagaraj, Naveen G., Nuding, Sebastian, Toma, Catalin, Gudzenko, Vadim, Stemmler, Hans Joachim, Pappalardo, Federico, Trummer, Georg, Benk, Christoph, Michels, Guido, Duerschmied, Daniel, von zur Muehlen, Constantin, Bode, Christoph, Kaier, Klaus, Brodie, Daniel, Wengenmayer, Tobias, Staudacher, Dawid L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997249/
https://www.ncbi.nlm.nih.gov/pubmed/33673615
http://dx.doi.org/10.3390/membranes11030170
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author Supady, Alexander
DellaVolpe, Jeff
Taccone, Fabio Silvio
Scharpf, Dominik
Ulmer, Matthias
Lepper, Philipp M.
Halbe, Maximilian
Ziegeler, Stephan
Vogt, Alexander
Ramanan, Raj
Boldt, David
Stecher, Stephanie-Susanne
Montisci, Andrea
Spangenberg, Tobias
Marggraf, Olivier
Kunavarapu, Chandra
Peluso, Lorenzo
Muenz, Sebastian
Buerle, Monica
Nagaraj, Naveen G.
Nuding, Sebastian
Toma, Catalin
Gudzenko, Vadim
Stemmler, Hans Joachim
Pappalardo, Federico
Trummer, Georg
Benk, Christoph
Michels, Guido
Duerschmied, Daniel
von zur Muehlen, Constantin
Bode, Christoph
Kaier, Klaus
Brodie, Daniel
Wengenmayer, Tobias
Staudacher, Dawid L.
author_facet Supady, Alexander
DellaVolpe, Jeff
Taccone, Fabio Silvio
Scharpf, Dominik
Ulmer, Matthias
Lepper, Philipp M.
Halbe, Maximilian
Ziegeler, Stephan
Vogt, Alexander
Ramanan, Raj
Boldt, David
Stecher, Stephanie-Susanne
Montisci, Andrea
Spangenberg, Tobias
Marggraf, Olivier
Kunavarapu, Chandra
Peluso, Lorenzo
Muenz, Sebastian
Buerle, Monica
Nagaraj, Naveen G.
Nuding, Sebastian
Toma, Catalin
Gudzenko, Vadim
Stemmler, Hans Joachim
Pappalardo, Federico
Trummer, Georg
Benk, Christoph
Michels, Guido
Duerschmied, Daniel
von zur Muehlen, Constantin
Bode, Christoph
Kaier, Klaus
Brodie, Daniel
Wengenmayer, Tobias
Staudacher, Dawid L.
author_sort Supady, Alexander
collection PubMed
description The role of veno-venous extracorporeal membrane oxygenation therapy (V-V ECMO) in severe COVID-19 acute respiratory distress syndrome (ARDS) is still under debate and conclusive data from large cohorts are scarce. Furthermore, criteria for the selection of patients that benefit most from this highly invasive and resource-demanding therapy are yet to be defined. In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival. Methods: This is an investigator-initiated retrospective non-interventional international multicenter registry study (NCT04405973, first registered 28 May 2020). In 127 patients treated with V-V ECMO at 15 centers in Germany, Switzerland, Italy, Belgium, and the United States, we calculated the Sequential Organ Failure Assessment (SOFA) Score, Simplified Acute Physiology Score II (SAPS II), Acute Physiology And Chronic Health Evaluation II (APACHE II) Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) Score, Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) Score, and 30-day survival. Results: In our study cohort which enrolled 127 patients, overall 30-day survival was 54%. Median SOFA, SAPS II, APACHE II, RESP, and PRESERVE were 9, 36, 17, 1, and 4, respectively. The prognostic accuracy for all these scores (area under the receiver operating characteristic—AUROC) ranged between 0.548 and 0.605. Conclusions: The use of scores for the prediction of mortality cannot be recommended for treatment decisions in severe COVID-19 ARDS undergoing V-V ECMO; nevertheless, scoring results below or above a specific cut-off value may be considered as an additional tool in the evaluation of prognosis. Survival rates in this cohort of COVID-19 patients treated with V-V ECMO were slightly lower than those reported in non-COVID-19 ARDS patients treated with V-V ECMO.
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spelling pubmed-79972492021-03-27 Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study Supady, Alexander DellaVolpe, Jeff Taccone, Fabio Silvio Scharpf, Dominik Ulmer, Matthias Lepper, Philipp M. Halbe, Maximilian Ziegeler, Stephan Vogt, Alexander Ramanan, Raj Boldt, David Stecher, Stephanie-Susanne Montisci, Andrea Spangenberg, Tobias Marggraf, Olivier Kunavarapu, Chandra Peluso, Lorenzo Muenz, Sebastian Buerle, Monica Nagaraj, Naveen G. Nuding, Sebastian Toma, Catalin Gudzenko, Vadim Stemmler, Hans Joachim Pappalardo, Federico Trummer, Georg Benk, Christoph Michels, Guido Duerschmied, Daniel von zur Muehlen, Constantin Bode, Christoph Kaier, Klaus Brodie, Daniel Wengenmayer, Tobias Staudacher, Dawid L. Membranes (Basel) Article The role of veno-venous extracorporeal membrane oxygenation therapy (V-V ECMO) in severe COVID-19 acute respiratory distress syndrome (ARDS) is still under debate and conclusive data from large cohorts are scarce. Furthermore, criteria for the selection of patients that benefit most from this highly invasive and resource-demanding therapy are yet to be defined. In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival. Methods: This is an investigator-initiated retrospective non-interventional international multicenter registry study (NCT04405973, first registered 28 May 2020). In 127 patients treated with V-V ECMO at 15 centers in Germany, Switzerland, Italy, Belgium, and the United States, we calculated the Sequential Organ Failure Assessment (SOFA) Score, Simplified Acute Physiology Score II (SAPS II), Acute Physiology And Chronic Health Evaluation II (APACHE II) Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) Score, Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) Score, and 30-day survival. Results: In our study cohort which enrolled 127 patients, overall 30-day survival was 54%. Median SOFA, SAPS II, APACHE II, RESP, and PRESERVE were 9, 36, 17, 1, and 4, respectively. The prognostic accuracy for all these scores (area under the receiver operating characteristic—AUROC) ranged between 0.548 and 0.605. Conclusions: The use of scores for the prediction of mortality cannot be recommended for treatment decisions in severe COVID-19 ARDS undergoing V-V ECMO; nevertheless, scoring results below or above a specific cut-off value may be considered as an additional tool in the evaluation of prognosis. Survival rates in this cohort of COVID-19 patients treated with V-V ECMO were slightly lower than those reported in non-COVID-19 ARDS patients treated with V-V ECMO. MDPI 2021-02-27 /pmc/articles/PMC7997249/ /pubmed/33673615 http://dx.doi.org/10.3390/membranes11030170 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Supady, Alexander
DellaVolpe, Jeff
Taccone, Fabio Silvio
Scharpf, Dominik
Ulmer, Matthias
Lepper, Philipp M.
Halbe, Maximilian
Ziegeler, Stephan
Vogt, Alexander
Ramanan, Raj
Boldt, David
Stecher, Stephanie-Susanne
Montisci, Andrea
Spangenberg, Tobias
Marggraf, Olivier
Kunavarapu, Chandra
Peluso, Lorenzo
Muenz, Sebastian
Buerle, Monica
Nagaraj, Naveen G.
Nuding, Sebastian
Toma, Catalin
Gudzenko, Vadim
Stemmler, Hans Joachim
Pappalardo, Federico
Trummer, Georg
Benk, Christoph
Michels, Guido
Duerschmied, Daniel
von zur Muehlen, Constantin
Bode, Christoph
Kaier, Klaus
Brodie, Daniel
Wengenmayer, Tobias
Staudacher, Dawid L.
Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study
title Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study
title_full Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study
title_fullStr Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study
title_full_unstemmed Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study
title_short Outcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation—A Retrospective International Multicenter Study
title_sort outcome prediction in patients with severe covid-19 requiring extracorporeal membrane oxygenation—a retrospective international multicenter study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997249/
https://www.ncbi.nlm.nih.gov/pubmed/33673615
http://dx.doi.org/10.3390/membranes11030170
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