Background: The novel coronavirus disease 2019 (COVID-19) pandemic has become a global health crisis affecting over 200 countries worldwide. Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the management of COVID-19-associated end-stage respiratory failure. However, the exact effect of ECMO in the management of these patients, especially with regards to complications and mortality, is unclear. Methods: This is the largest retrospective study of ECMO treated COVID-19 patients in China. A total of 50 ECMO-treated COVID-19 patients were recruited. We describe the main characteristics, the clinical features, ventilator parameters, ECMO-related variables and management details, and complications and outcomes of COVID-19 patients with severe acute respiratory distress syndrome (ARDS) that required ECMO support. Results: For those patients with ECMO support, 21 patients survived and 29 died (mortality rate: 58.0%). Among those who survived, PaO 2 (66.3 mmHg [59.5–74.0 mmHg] and PaO 2 /FiO 2 (68.0 mmHg [61.0–76.0 mmHg]) were higher in the survivors than those of non-survivors (PaO 2 : 56.8 mmHg (49.0–65.0 mmHg), PaO 2 /FiO 2 (58.2 mmHg (49.0–68.0 mmHg), all P < 0.01) prior to ECMO. Patients who achieved negative fluid balance in the early resuscitation phase (within 3 days) had a higher survival rate than those who did not ( P = 0.0003). Conclusions: In this study of 50 cases of ECMO-treated COVID-19 patients, a low PO 2 /FIO 2 ratio before ECMO commencement may indicate a poor prognosis. Negative fluid balance in the early resuscitation phase during ECMO treatment was a predictor of increased survival post-ECMO treatment.
【저자키워드】 China, Severe acute respiratory syndrome, management, Coronavirus (COVID-19), Extracorporeal membrane oxygenation (ECMO), 【초록키워드】 COVID-19, Treatment, ARDS, pandemic, Respiratory failure, Mortality, outcome, novel coronavirus disease, Clinical features, Retrospective study, Health, Characteristics, Patient, Complication, ECMO, membrane, survival rate, patients, COVID-19 patients, acute respiratory distress, COVID-19 patient, Extracorporeal, Oxygenation, Support, increased survival, syndrome, poor prognosis, ventilator parameters, survivor, variable, negative, country, non-survivor, died, recruited, required, treated, affecting, survived, increasingly, PaO, those who survived, 【제목키워드】 COVID-19, ARDS, Extracorporeal,