PDF(Pubmed)
Abstract：
UNASSIGNED: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) therapy is being increasingly used as respiratory support for patients with severe coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (ARDS). However, the long-term outcome of VV-ECMO as a bridge to lung transplantation in COVID-19-associated ARDS remains unclear, hence the purpose of this study aimed to evaluate its long-term outcome, safety, and feasibility.
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.
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.
摘要：
■静脉-静脉体外膜氧合（VV-ECMO）疗法越来越多地用作严重冠状病毒病2019（COVID-19）相关急性呼吸窘迫综合征（ARDS）患者的呼吸支持。然而,VV-ECMO作为COVID-19相关ARDS肺移植桥梁的长期结局尚不清楚，因此，这项研究的目的是评估其长期结果，安全,和可行性。
■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。
■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。
