Worldwide application and valuation of extracorporeal membrane oxygenation support during the COVID-19 pandemic (WAVES)
Year: 2024
Type: article
Study design: Observational Study
Abstract: ObjectiveThe outcomes of COVID-19 patients on venovenous extracorporeal membrane oxygenation (VV-ECMO) varied. We aim to investigate the variability concerning location and timeframe. We conducted a retrospective analysis of data from 351 institutions in 53 countries. The primary outcome was survival to hospital discharge or death up to 90 days from ECMO start. The associations between calendar time (month and year) of ECMO initiation and the primary outcome were examined by Cox regression modeling. Multivariable survival analyses were adjusted for the time of ECMO start, age, body mass index, APACHE II, SOFA, and the duration of mechanical ventilation before ECMO.Results1060 adult COVID-19 patients enrolled in the COVID-19 Critical Care Consortium (COVID Critical) international registry and required VV-ECMO support. The study period is from January 2020 to December 2021. The median age was 51 years old, and 70% were male patients. Most patients were from Europe (39.3%) and North America (37.4%). The in-hospital mortality of the entire cohort was 47.12%. In North America and Europe, there was an increased probability of death from May 2020 through February 2021. Latin America showed a steady rate of survival until late in the study. South Asia, the Middle East, and Africa showed an increased chance of mortality around May 2020. In the Asian-Pacific region, after February 2021, there was an increased probability of death. The time of ECMO initiation and advanced patient age were associated with increased mortality.ConclusionVariability in the outcomes of COVID-19 patients on VV-ECMO existed within different regions. This variability reflects the differences in resources, policies, patient selection, management, and possibly COVID-19 virus subtypes. Our findings might help guide global response in the future by early adoption of patient selection protocols, worldwide policies, and delivery of resources.
Source: Perfusion
Institutions: University of Virginia, The University of Queensland, North Estonia Medical Centre, Prince Charles Hospital, Commonwealth Scientific and Industrial Research Organisation, Queensland University of Technology, Australian e-Health Research Centre, CSIRO Health and Biosecurity, University of Utah, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Hamad General Hospital, Weill Cornell Medical College in Qatar, Weill Cornell Medicine, Boston Children's Hospital, Harvard University, University of Florida Health, University of Florida, Inova Fairfax Hospital, Inova Children's Hospital, Maastricht University Medical Centre, Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: green
Awards: Pediatric ECMO Anticoagulation Collaborative (PEACE) Consensus, The Prince Charles Hospital Foundation - This project will help develop capabilities for federated data sharing with clinical outcome data from COVID treated patients., G3897007235, G7108608281, CLots and Oxygen in Va-ExtracorpoReal membrane oxygenation (CLOVER) study
OpenAlex ID: W4400945233