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dc.contributor.authorBarbaro, RP
dc.contributor.authorMacLaren, G
dc.contributor.authorBoonstra, PS
dc.contributor.authorIwashyna, TJ
dc.contributor.authorSlutsky, AS
dc.contributor.authorFan, E
dc.contributor.authorBartlett, RH
dc.contributor.authorTonna, JE
dc.contributor.authorHyslop, R
dc.contributor.authorFanning, JJ
dc.contributor.authorRycus, PT
dc.contributor.authorHyer, SJ
dc.contributor.authorAnders, MM
dc.contributor.authorAgerstrand, CL
dc.contributor.authorHryniewicz, K
dc.contributor.authorDiaz, R
dc.contributor.authorLorusso, R
dc.contributor.authorCombes, A
dc.contributor.authorBrodie, D
dc.date.accessioned2020-12-16T23:49:55Z
dc.date.available2020-12-16T23:49:55Z
dc.date.issued2020-10-10
dc.identifierpii: S0140-6736(20)32008-0
dc.identifier.citationBarbaro, R. P., MacLaren, G., Boonstra, P. S., Iwashyna, T. J., Slutsky, A. S., Fan, E., Bartlett, R. H., Tonna, J. E., Hyslop, R., Fanning, J. J., Rycus, P. T., Hyer, S. J., Anders, M. M., Agerstrand, C. L., Hryniewicz, K., Diaz, R., Lorusso, R., Combes, A. & Brodie, D. (2020). Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. LANCET, 396 (10257), pp.1071-1078. https://doi.org/10.1016/S0140-6736(20)32008-0.
dc.identifier.issn0140-6736
dc.identifier.urihttp://hdl.handle.net/11343/254577
dc.description.abstractBACKGROUND: Multiple major health organisations recommend the use of extracorporeal membrane oxygenation (ECMO) support for COVID-19-related acute hypoxaemic respiratory failure. However, initial reports of ECMO use in patients with COVID-19 described very high mortality and there have been no large, international cohort studies of ECMO for COVID-19 reported to date. METHODS: We used data from the Extracorporeal Life Support Organization (ELSO) Registry to characterise the epidemiology, hospital course, and outcomes of patients aged 16 years or older with confirmed COVID-19 who had ECMO support initiated between Jan 16 and May 1, 2020, at 213 hospitals in 36 countries. The primary outcome was in-hospital death in a time-to-event analysis assessed at 90 days after ECMO initiation. We applied a multivariable Cox model to examine whether patient and hospital factors were associated with in-hospital mortality. FINDINGS: Data for 1035 patients with COVID-19 who received ECMO support were included in this study. Of these, 67 (6%) remained hospitalised, 311 (30%) were discharged home or to an acute rehabilitation centre, 101 (10%) were discharged to a long-term acute care centre or unspecified location, 176 (17%) were discharged to another hospital, and 380 (37%) died. The estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 37·4% (95% CI 34·4-40·4). Mortality was 39% (380 of 968) in patients with a final disposition of death or hospital discharge. The use of ECMO for circulatory support was independently associated with higher in-hospital mortality (hazard ratio 1·89, 95% CI 1·20-2·97). In the subset of patients with COVID-19 receiving respiratory (venovenous) ECMO and characterised as having acute respiratory distress syndrome, the estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 38·0% (95% CI 34·6-41·5). INTERPRETATION: In patients with COVID-19 who received ECMO, both estimated mortality 90 days after ECMO and mortality in those with a final disposition of death or discharge were less than 40%. These data from 213 hospitals worldwide provide a generalisable estimate of ECMO mortality in the setting of COVID-19. FUNDING: None.
dc.languageEnglish
dc.publisherELSEVIER SCIENCE INC
dc.titleExtracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry
dc.typeJournal Article
dc.identifier.doi10.1016/S0140-6736(20)32008-0
melbourne.affiliation.departmentPaediatrics (RCH)
melbourne.source.titleThe Lancet
melbourne.source.volume396
melbourne.source.issue10257
melbourne.source.pages1071-1078
melbourne.elementsid1468839
melbourne.openaccess.urlhttps://europepmc.org/articles/PMC7518880?pdf=render
melbourne.openaccess.statusPublished version
melbourne.contributor.authorMacLaren, Graeme
dc.identifier.eissn1474-547X
melbourne.accessrightsAccess this item via the Open Access location


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