• Intensive care medicine · Apr 2022

    Multicenter Study

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

    • Stephen Whebell, Joe Zhang, Rebecca Lewis, Michael Berry, Stephane Ledot, Andrew Retter, and Luigi Camporota.
    • Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK. swhebell@gmail.com.
    • Intensive Care Med. 2022 Apr 1; 48 (4): 467-478.

    PurposeExtracorporeal 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.MethodsA 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.Results1363 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.ConclusionWe found ECMO provided at specialist centres conferred significant survival benefit. Where resources and specialism allow, ECMO should be widely offered.© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.

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