Venovenous extracorporeal membrane oxygenation for COVID-19 and influenza H1N1 associated acute respiratory distress syndrome: A comparative cohort study in China

Yonghao Xu; Yin Xi; Shuijiang Cai; Yuheng Yu; Sibei Chen; Weijie Guan; Weibo Liang; Hongkai Wu; Weiqun He; Xilong Deng; Yuanda Xu; Rong Zhang; Manshu Li; Jieyi Pan; Zhenting Liang; Ya Wang; Shaofeng Kong; Xiaoqing Liu; Zheng Lv; Yimin Li

Journal of Intensive Medicine (Oct 2023)

Venovenous extracorporeal membrane oxygenation for COVID-19 and influenza H1N1 associated acute respiratory distress syndrome: A comparative cohort study in China

Yonghao Xu,
Yin Xi,
Shuijiang Cai,
Yuheng Yu,
Sibei Chen,
Weijie Guan,
Weibo Liang,
Hongkai Wu,
Weiqun He,
Xilong Deng,
Yuanda Xu,
Rong Zhang,
Manshu Li,
Jieyi Pan,
Zhenting Liang,
Ya Wang,
Shaofeng Kong,
Xiaoqing Liu,
Zheng Lv,
Yimin Li

Affiliations

Yonghao Xu: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Yin Xi: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China; Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Shuijiang Cai: Department of Critical Care Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
Yuheng Yu: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China; Department of Critical Care Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
Sibei Chen: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Weijie Guan: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Weibo Liang: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Hongkai Wu: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Weiqun He: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China; Department of Critical Care Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
Xilong Deng: Department of Critical Care Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
Yuanda Xu: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China; Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Rong Zhang: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Manshu Li: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Jieyi Pan: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Zhenting Liang: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Ya Wang: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
Shaofeng Kong: Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
Xiaoqing Liu: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China; Corresponding authors: Zheng Lv, Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China; Yimin Li, Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510000, Guangdong, China; Xiaoqing Liu, Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510000, Guangdong, China.
Zheng Lv: Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Corresponding authors: Zheng Lv, Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China; Yimin Li, Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510000, Guangdong, China; Xiaoqing Liu, Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510000, Guangdong, China.
Yimin Li: Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China; Corresponding authors: Zheng Lv, Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China; Yimin Li, Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510000, Guangdong, China; Xiaoqing Liu, Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510000, Guangdong, China.

Journal volume & issue: Vol. 3, no. 4
pp. 326 – 334

Abstract

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Background: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been demonstrated to be effective in treating patients with virus-induced acute respiratory distress syndrome (ARDS). However, whether the management of ECMO is different in treating H1N1 influenza and coronavirus disease 2019 (COVID-19)-associated ARDS patients remains unknown. Methods: This is a retrospective cohort study. We included 12 VV-ECMO-supported COVID-19 patients admitted to The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Eighth People's Hospital, and Wuhan Union Hospital West Campus between January 23 and March 31, 2020. We retrospectively included VV-ECMO-supported patients with COVID-19 and H1N1 influenza-associated ARDS. Clinical characteristics, respiratory mechanics including plateau pressure, driving pressure, mechanical power, ventilatory ratio (VR) and lung compliance, and outcomes were compared. Results: Data from 25 patients with COVID-19 (n=12) and H1N1 (n=13) associated ARDS who had received ECMO support were analyzed. COVID-19 patients were older than H1N1 influenza patients (P=0.004). The partial pressure of arterial carbon dioxide (PaCO2) and VR before ECMO initiation were significantly higher in COVID-19 patients than in H1N1 influenza patients (P <0.001 and P=0.004, respectively). COVID-19 patients showed increased plateau and driving pressure compared with H1N1 subjects (P=0.013 and P=0.018, respectively). Patients with COVID-19 remained longer on ECMO support than did H1N1 influenza patients (P=0.015). COVID-19 patients who required ECMO support also had fewer intensive care unit and ventilator-free days than H1N1. Conclusions: Compared with H1N1 influenza patients, COVID-19 patients were older and presented with increased PaCO2 and VR values before ECMO initiation. The differences between ARDS patients with COVID-19 and influenza on VV-ECMO detailed herein could be helpful for obtaining a better understanding of COVID-19 and for better clinical management.

Published in Journal of Intensive Medicine

ISSN: 2667-100X (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://www.journals.elsevier.com/journal-of-intensive-medicine

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