摘要
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(PaCO_(2))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 PaCO_(2) 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.
基金
support from the Special Project of the Guangdong Science and Technology Department (grant number:2020B1111340013)
Mergency Key Program of Guangzhou Laboratory (grant number:EKPG21-29)
Guangzhou City School (Institute)Joint Funding Project (grant number:202201020414)
the National Natural Science Foundation of China (grant number:81970071).
