PDF(Pubmed)
Abstract：
Background: The COVID-19 pandemic caused an unprecedented number of patients requiring veno-venous extracorporeal membrane oxygenation (VV ECMO) therapy. Clinical polyuria was observed at our ECMO center during the pandemic. This study aims to investigate the incidence, potential causes, and implications of polyuria in COVID-19 patients undergoing VV ECMO therapy. Methods: Here, 68 SARS-CoV-2 positive patients receiving VV ECMO were stratified into the following two groups: polyuria (PU), characterized by an average urine output of ≥3000 mL/day within seven days following initiation, and non-polyuria (NPU), defined by <3000 mL/day. Polyuria in ECMO patients occurred in 51.5% (n = 35) within seven days after ECMO initiation. No significant difference in mortality was observed between PU and NPU groups (60.0% vs. 60.6%). Differences were found in the fluid intake (p < 0.01) and balance within 24 h (p = 0.01), creatinine (p < 0.01), plasma osmolality (p = < 0.01), lactate (p < 0.01), urea (p < 0.01), and sodium levels (p < 0.01) between the groups. Plasma osmolality increased (p < 0.01) after ECMO initiation during the observation period. Results: Diuresis and plasma osmolality increased during VV ECMO treatment, while mortality was not affected by polyuria. Conclusions: Polyuria does not appear to impact mortality. Further investigations are warranted to elucidate its underlying mechanisms and clinical implications in the context of VV ECMO therapy and COVID-19 management.
摘要：
背景：COVID-19大流行导致需要静脉-静脉体外膜氧合（VVECMO）治疗的患者数量空前。在大流行期间，我们的ECMO中心观察到临床多尿。本研究旨在调查发病率，潜在原因,接受VVECMO治疗的COVID-19患者多尿的影响。方法:这里,68例接受VVECMO的SARS-CoV-2阳性患者分为以下两组：多尿（PU），以开始后七天内平均尿量≥3000毫升/天为特征，和非多尿（NPU），定义为<3000毫升/天。ECMO患者中51.5%(n=35)的多尿发生在ECMO开始后7天内。PU组和NPU组之间的死亡率没有显着差异（60.0％vs.60.6%）。在24小时内（p=0.01）和平衡中发现了液体摄入量（p<0.01）的差异，肌酐（p<0.01），血浆渗透压（p=<0.01），乳酸（p<0.01），尿素（p<0.01），两组之间的钠水平（p<0.01）。在观察期间开始ECMO后，血浆渗透压增加（p<0.01）。结果：VVECMO治疗期间利尿和血浆渗透压增加，而死亡率不受多尿症的影响。结论：多尿似乎不影响死亡率。需要进一步的研究来阐明其在VVECMO治疗和COVID-19治疗背景下的潜在机制和临床意义。
