UNASSIGNED: This was a retrospective cohort study from an institutional lung transplantation database between June 2020 and June 2022. Data on demographics, pre-transplantation laboratory values, postoperative outcomes, preoperative and postoperative transthoracic echocardiography findings, and survival rates were collected. Chi-square, Mann-Whitney U, Student\'s t, Kaplan-Meier, and Wilcoxon signed-rank tests were used for analysis.
UNASSIGNED: Twenty-five patients with COVID-19-associated ARDS underwent lung transplant surgery with VV-ECMO bridge. Unfortunately, six patients with COVID-19-associated ARDS using VV-ECMO died while waiting for transplantation during the same study period. Patients with VV-ECMO bridge were a more severe cohort than 16 patients without VV-ECMO bridge (lung allocation score: 88.1 vs. 74.9, P<0.001). These patients had longer intensive care unit and hospital stays (P=0.03 and P=0.02, respectively) and a higher incidence of complications after lung transplantation. The one-year survival rate of patients with VV-ECMO bridge was lower than that of patients without (78.3% vs. 100.0%, P=0.06), but comparable to that of patients with other lung transplant indications (84.2%, P=0.95). Echocardiography showed a decrease in the right ventricular systolic pressure (P=0.01), confirming that lung transplantation improved right heart function.
UNASSIGNED: Our findings suggest that VV-ECMO can be used to safely bridge patients with COVID-19 associated ARDS with right heart failure.
■这是一项回顾性队列研究,来自2020年6月至2022年6月的机构肺移植数据库。人口统计数据,移植前实验室值,术后结果,术前和术后经胸超声心动图检查结果,并收集存活率。卡方,Mann-WhitneyU,学生t,Kaplan-Meier,和Wilcoxon符号秩检验用于分析。
■25例COVID-19相关ARDS患者接受了VV-ECMO桥肺移植手术。不幸的是,在同一研究期间,6例使用VV-ECMO的COVID-19相关ARDS患者在等待移植时死亡.VV-ECMO桥的患者比16例无VV-ECMO桥的患者更严重(肺分配评分:88.1与74.9,P<0.001)。这些患者的重症监护病房和住院时间更长(分别为P=0.03和P=0.02),肺移植后并发症的发生率更高。VV-ECMO桥患者的一年生存率低于无VV-ECMO桥患者(78.3%vs.100.0%,P=0.06),但与其他肺移植适应症患者相当(84.2%,P=0.95)。超声心动图显示右心室收缩压下降(P=0.01),证实肺移植改善了右心功能。
■我们的研究结果表明,VV-ECMO可用于安全地桥接COVID-19相关ARDS患者和右心衰竭。