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Multicenter Study
. 2022 Apr;48(4):467-478.
doi: 10.1007/s00134-022-06645-w. Epub 2022 Mar 3.

Survival benefit of extracorporeal membrane oxygenation in severe COVID-19: a multi-centre-matched cohort study

Stephen Whebell  1   2 , Joe Zhang  3   4 , Rebecca Lewis  5 , Michael Berry  3 , Stephane Ledot  6 , Andrew Retter  5 , Luigi Camporota  5   7
Affiliations
Multicenter Study

Survival benefit of extracorporeal membrane oxygenation in severe COVID-19: a multi-centre-matched cohort study

Stephen Whebell et al. Intensive Care Med. 2022 Apr.

Erratum in

Abstract

Purpose: Extracorporeal membrane oxygenation (ECMO) has become an established therapy for severe respiratory failure in coronavirus disease 2019 (COVID-19). The added benefit of receiving ECMO in COVID-19 remains uncertain. The aim of this study is to analyse the impact of receiving ECMO at specialist centres on hospital mortality.

Methods: A multi-centre retrospective study was conducted in COVID-19 patients from 111 hospitals, referred to two specialist ECMO centres in the United Kingdom (UK) (March 2020 to February 2021). Detailed covariate data were contemporaneously curated from electronic referral systems. We analysed added benefit of ECMO treatment in specialist centres using propensity score matching techniques.

Results: 1363 patients, 243 receiving ECMO, were analysed. The best matching technique generated 209 matches, with a marginal odds ratio (OR) for mortality of 0.44 (95% CI 0.29-0.68, p < 0.001) and absolute mortality reduction of 18.2% (44% vs 25.8%, p < 0.001) for treatment with ECMO in a specialist centre.

Conclusion: We found ECMO provided at specialist centres conferred significant survival benefit. Where resources and specialism allow, ECMO should be widely offered.

Keywords: ARDS; COVID-19; ECMO; Severe respiratory failure.

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Conflict of interest statement

This study received no direct funding. JZ receives funding from the Wellcome Trust (203928/Z/16/Z) and acknowledges support from the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College NHS Trust and Imperial College London. Other authors have no financial or non-financial competing interests to declare.

Figures

Fig. 1
Fig. 1
Flow chart of patient inclusion, exclusion and sensitivity analyses
Fig. 2
Fig. 2
Histogram of referrals for consideration of ECMO grouped by 7-day period with treatment and outcome shown
See this image and copyright information in PMC

Comment in

References

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