Extracorporeal Membrane Oxygenation for COVID-19–associated Severe Acute Respiratory Distress Syndrome in Chile

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dc.contributor.authorDíaz, Rodrigo A.
dc.contributor.authorGraf, Jerónimo
dc.contributor.authorZambrano, José M.
dc.contributor.authorRuiz, Carolina
dc.contributor.authorEspinoza, Juan A.
dc.contributor.authorBravo, Sebastián 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, Andrés
dc.contributor.authorFerreira, Leonila L.
dc.contributor.authorValenzuela, Josefa
dc.contributor.authorCastillo, Roberto E.
dc.contributor.authorPérez-Araos, Rodrigo
dc.contributor.authorBravo, Marcela
dc.contributor.authorAquevedo, Andrés F.
dc.contributor.authorGonzález, Mauricio G.
dc.contributor.authorPereira, Rodrigo
dc.contributor.authorOrtega, Leandro
dc.contributor.authorSantis, Cesar
dc.contributor.authorFernández, Paula A.
dc.contributor.authorCortés, Vilma
dc.contributor.authorCornejo, Rodrigo A.
dc.date.accessioned2022-03-29T14:52:48Z
dc.date.available2022-03-29T14:52:48Z
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. Objectives: 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. Methods: 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. Measurements 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. Conclusions: Documenting nationwide ECMO needs may help in planning ECMO provision 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.es
dc.description.versionVersión Publicadaes
dc.identifier.citationiaz RA, Graf J, Zambrano JM, Ruiz C, Espinoza JA, Bravo SI, Salazar PA, Bahamondes JC, Castillo LB, Gajardo AIJ, Kursbaum A, Ferreira LL, Valenzuela J, Castillo RE, Pérez-Araos RA, Bravo M, Aquevedo AF, González MG, Pereira R, Ortega L, Santis C, Fernández PA, Cortés V, Cornejo RA. Extracorporeal Membrane Oxygenation for COVID-19-associated Severe Acute Respiratory Distress Syndrome in Chile: A Nationwide Incidence and Cohort Study. Am J Respir Crit Care Med. 2021 Jul 1;204(1):34-43. doi: 10.1164/rccm.202011-4166OCes
dc.identifier.urihttps://doi.org/10.1164/rccm.202011-4166OCes
dc.identifier.urihttp://hdl.handle.net/11447/5842
dc.language.isoenes
dc.subjectExtracorporeal membrane oxygenationes
dc.subjectCovid-19es
dc.subjectSevere acute respiratory distress syndromees
dc.subjectPandemices
dc.titleExtracorporeal Membrane Oxygenation for COVID-19–associated Severe Acute Respiratory Distress Syndrome in Chilees
dc.typeArticlees
dcterms.sourceAmerican Journal of Respiratory and Critical Care Medicinees

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