Status of COVID-19 Patients Treated With Extracorporeal Membrane Oxygenation in Japan: Nationwide Database Analysis

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Jun 13

PMID 38868250

Authors

Tomoki Kuribara

Yusuke Asai

Norio Ohmagari

Isao Yokota

Affiliations

Soon will be listed here.

Abstract

Background The report of epidemiological data on coronavirus disease 2019 (COVID-19) patients treated using extracorporeal membrane oxygenation (ECMO) in Japan has been limited. Our study seeks to fill the existing gap in knowledge by providing an in-depth analysis of the clinical epidemiological characteristics and diverse medical outcomes of COVID-19 patients treated with ECMO in Japan. Methods This study used the COVID-19 Registry Japan nationwide database. We included patients aged 18 years or older enrolled between March 17, 2020, and February 1, 2022, with traceable ECMO data. The items on clinical epidemiological characteristics and various medical outcomes were collected. Statistical analysis included a median and interquartile range (IQR) for continuous variables and frequencies for categorical variables. Results The number of participating hospitals was 731, and the number of patients enrolled for analysis was 49,590. Of these, 196 (0.4%) patients received ECMO. Hospital mortality was 33.2%, and discharge to home was 23.0% in the ECMO group. The complications during hospitalization included pneumothorax (9.7%), seizures (4.1%), stroke (4.6%), and pulmonary thromboembolism (2.0%). At discharge, 38.3% had worsened self-care ability, and 38.8% had worsened ambulatory function. Conclusions The results of ECMO treatment in Japan showed that the mortality and complication rates were well-controlled compared with those worldwide.

References

Lorusso R, De Piero M, Mariani S, Di Mauro M, Folliguet T, Taccone F . In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study. Lancet Respir Med. 2022; 11(2):151-162. PMC: 9671669. DOI: 10.1016/S2213-2600(22)00403-9. View

Ohshimo S, Liu K, Ogura T, Iwashita Y, Kushimoto S, Shime N . Trends in survival during the pandemic in patients with critical COVID-19 receiving mechanical ventilation with or without ECMO: analysis of the Japanese national registry data. Crit Care. 2022; 26(1):354. PMC: 9664428. DOI: 10.1186/s13054-022-04187-7. View

Mansour A, Flecher E, Schmidt M, Rozec B, Gouin-Thibault I, Esvan M . Bleeding and thrombotic events in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study. Intensive Care Med. 2022; 48(8):1039-1052. DOI: 10.1007/s00134-022-06794-y. View

Barbaro R, MacLaren G, Boonstra P, Iwashyna T, Slutsky A, Fan E . Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet. 2020; 396(10257):1071-1078. PMC: 7518880. DOI: 10.1016/S0140-6736(20)32008-0. View

Northam K, Murray B, Fischer W, Charles A . Major Bleeding and Thrombosis Events in COVID-19 Versus Influenza Patients Requiring Extracorporeal Membrane Oxygenation. ASAIO J. 2022; 68(6):779-784. DOI: 10.1097/MAT.0000000000001667. View

Cousin N, Bourel C, Carpentier D, Goutay J, Mugnier A, Labreuche J . SARS-CoV-2 Versus Influenza-associated Acute Respiratory Distress Syndrome Requiring Veno-venous Extracorporeal Membrane Oxygenation Support. ASAIO J. 2020; 67(2):125-131. PMC: 7846248. DOI: 10.1097/MAT.0000000000001325. View

van Seben R, Reichardt L, Aarden J, van der Schaaf M, van der Esch M, Engelbert R . The Course of Geriatric Syndromes in Acutely Hospitalized Older Adults: The Hospital-ADL Study. J Am Med Dir Assoc. 2018; 20(2):152-158.e2. DOI: 10.1016/j.jamda.2018.08.003. View

Forchette L, Sebastian W, Liu T . A Comprehensive Review of COVID-19 Virology, Vaccines, Variants, and Therapeutics. Curr Med Sci. 2021; 41(6):1037-1051. PMC: 8267225. DOI: 10.1007/s11596-021-2395-1. View

Masur J, Freeman C, Mohan S . A Double-Edged Sword: Neurologic Complications and Mortality in Extracorporeal Membrane Oxygenation Therapy for COVID-19-Related Severe Acute Respiratory Distress Syndrome at a Tertiary Care Center. AJNR Am J Neuroradiol. 2020; 41(11):2009-2011. PMC: 7658835. DOI: 10.3174/ajnr.A6728. View

10.

Arachchillage D, Rajakaruna I, Scott I, Gaspar M, Odho Z, Banya W . Impact of major bleeding and thrombosis on 180-day survival in patients with severe COVID-19 supported with veno-venous extracorporeal membrane oxygenation in the United Kingdom: a multicentre observational study. Br J Haematol. 2021; 196(3):566-576. PMC: 8653259. DOI: 10.1111/bjh.17870. View

11.

Zhang J, Merrick B, Correa G, Camporota L, Retter A, Doyle A . Veno-venous extracorporeal membrane oxygenation in coronavirus disease 2019: a case series. ERJ Open Res. 2020; 6(4). PMC: 7520944. DOI: 10.1183/23120541.00463-2020. View

12.

Brodie D, Slutsky A, Combes A . Extracorporeal Life Support for Adults With Respiratory Failure and Related Indications: A Review. JAMA. 2019; 322(6):557-568. DOI: 10.1001/jama.2019.9302. View

13.

Combes A, Peek G, Hajage D, Hardy P, Abrams D, Schmidt M . ECMO for severe ARDS: systematic review and individual patient data meta-analysis. Intensive Care Med. 2020; 46(11):2048-2057. PMC: 7537368. DOI: 10.1007/s00134-020-06248-3. View

14.

Bertini P, Guarracino F, Falcone M, Nardelli P, Landoni G, Nocci M . ECMO in COVID-19 Patients: A Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth. 2021; 36(8 Pt A):2700-2706. PMC: 8585556. DOI: 10.1053/j.jvca.2021.11.006. View

15.

Garfield B, Bianchi P, Arachchillage D, Hartley P, Naruka V, Shroff D . Six Month Mortality in Patients with COVID-19 and Non-COVID-19 Viral Pneumonitis Managed with Veno-Venous Extracorporeal Membrane Oxygenation. ASAIO J. 2021; 67(9):982-988. DOI: 10.1097/MAT.0000000000001527. View

16.

Friedrichson B, Kloka J, Neef V, Mutlak H, Old O, Zacharowski K . Extracorporeal membrane oxygenation in coronavirus disease 2019: A nationwide cohort analysis of 4279 runs from Germany. Eur J Anaesthesiol. 2022; 39(5):445-451. DOI: 10.1097/EJA.0000000000001670. View

17.

Biancari F, Mariscalco G, Dalen M, Settembre N, Welp H, Perrotti A . Six-Month Survival After Extracorporeal Membrane Oxygenation for Severe COVID-19. J Cardiothorac Vasc Anesth. 2021; 35(7):1999-2006. PMC: 7816613. DOI: 10.1053/j.jvca.2021.01.027. View

18.

Ogura T, Ohshimo S, Liu K, Iwashita Y, Hashimoto S, Takeda S . Establishment of a Disaster Management-like System for COVID-19 Patients Requiring Veno-Venous Extracorporeal Membrane Oxygenation in Japan. Membranes (Basel). 2021; 11(8). PMC: 8400005. DOI: 10.3390/membranes11080625. View

19.

Shaefi S, Brenner S, Gupta S, OGara B, Krajewski M, Charytan D . Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19. Intensive Care Med. 2021; 47(2):208-221. PMC: 7851810. DOI: 10.1007/s00134-020-06331-9. View

20.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344-9. DOI: 10.1016/j.jclinepi.2007.11.008. View