Extracorporeal Membrane Oxygenation for COVID-19-associated Severe Acute Respiratory Distress Syndrome in Chile A Nationwide Incidence and Cohort Study

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dc.contributor.authorDiaz, Rodrigo A.
dc.contributor.authorGraf, Jeronimo
dc.contributor.authorZambrano, Jose M.
dc.contributor.authorRuiz, Carolina
dc.contributor.authorEspinoza, Juan A.
dc.contributor.authorBravo, Sebastian, I
dc.contributor.authorSalazar, Pablo A.
dc.contributor.authorBahamondes, Juan C.
dc.contributor.authorCastillo, Luis B.
dc.contributor.authorGajardo, Abraham I. J.
dc.contributor.authorKursbaum, Andres
dc.contributor.authorFerreira, Leonila L.
dc.contributor.authorValenzuela, Josefa
dc.contributor.authorCastillo, Roberto E.
dc.contributor.authorPerez-Araos, Rodrigo A.
dc.contributor.authorBravo, Marcela
dc.contributor.authorAquevedo, Andres F.
dc.contributor.authorGonzalez, Mauricio G.
dc.contributor.authorPereira, Rodrigo
dc.contributor.authorOrtega, Leandro
dc.contributor.authorSantis, Cesar
dc.contributor.authorFernandez, Paula A.
dc.contributor.authorCortes, Vilma
dc.contributor.authorCornejo, Rodrigo A.
dc.date.accessioned2025-01-20T22:14:19Z
dc.date.available2025-01-20T22:14:19Z
dc.date.issued2021
dc.description.abstractRationale: The role of and needs for extracorporeal membrane oxygenation (ECMO) at a population level during the coronavirus disease (COVID-19) pandemic have not been completely established.
dc.description.abstractObjectives: To identify the cumulative incidence of ECMO use in the first pandemic wave and to describe the Nationwide Chilean cohort of ECMO-supported patients with COVID-19.
dc.description.abstractMethods: We conducted a population-based study from March 3 to August 31, 2020, using linked data from national agencies. The cumulative incidence of ECMO use and mortality risk of ECMO-supported patients were calculated and age standardized. In addition, a retrospective cohort analysis was performed. Outcomes were 90-day mortality after ECMO initiation, ECMO-associated complications, and hospital length of stay. Cox regression models were used to explore risk factors for mortality in a time-to-event analysis.
dc.description.abstractMeasurements and Main Results: Ninety-four patients with COVID-19 were supported with ECMO (0.42 per population of 100,000, 14.89 per 100,000 positive cases, and 1.2% of intubated patients with COVID-19); 85 were included in the cohort analysis, and the median age was 48 (interquartile range [IQR], 41-55) years, 83.5% were men, and 42.4% had obesity. The median number of pre-ECMO intubation days was 4 (IQR, 2-7), the median PaO2/FIO2 ratio was 86.8 (IQR, 64-99) mm Hg, 91.8% of patients were prone positioned, and 14 patients had refractory respiratory acidosis. Main complications were infections (70.6%), bleeding (38.8%), and thromboembolism (22.4%); 52 patients were discharged home, and 33 died. The hospital length of stay was a median of 50 (IQR, 24-69) days. Lower respiratory system compliance and higher driving pressure before ECMO initiation were associated with increased mortality. A duration of pre-ECMO intubation >10 days was not associated with mortality.
dc.description.abstractConclusions: Documenting nationwide ECMO needs may help in planning ECMOprovision for future COVID-19 pandemic waves. The 90-day mortality of the Chilean cohort of ECMO-supported patients with COVID-19 (38.8%) is comparable to that of previous reports.
dc.fuente.origenWOS
dc.identifier.doi10.1164/rccm.202011-4166OC
dc.identifier.eissn1535-4970
dc.identifier.issn1073-449X
dc.identifier.urihttps://doi.org/10.1164/rccm.202011-4166OC
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94477
dc.identifier.wosidWOS:000674175600011
dc.issue.numero1
dc.language.isoen
dc.pagina.final43
dc.pagina.inicio34
dc.revistaAmerican journal of respiratory and critical care medicine
dc.rightsacceso restringido
dc.subjectextracorporeal membrane oxygenation
dc.subjectCOVID-19
dc.subjectsevere acute respiratory distress syndrome
dc.subjectpandemic
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleExtracorporeal Membrane Oxygenation for COVID-19-associated Severe Acute Respiratory Distress Syndrome in Chile A Nationwide Incidence and Cohort Study
dc.typeartículo
dc.volumen204
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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