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Open Access 01-12-2024 | ECMO | Research

Potential for recovery after extremely prolonged VV-ECMO support in well-selected severe COVID-19 patients: a retrospective cohort study

Authors: Jean-Marc de Walque, Christophe de Terwangne, Raphaël Jungers, Sophie Pierard, Christophe Beauloye, Fatima Laarbaui, Melanie Dechamps, Luc Marie Jacquet

Published in: BMC Pulmonary Medicine | Issue 1/2024

Abstract

Background

VenoVenous ExtraCorporeal Membrane Oxygenation (VV-ECMO) has been widely used as supportive therapy for severe respiratory failure related to Acute Respiratory Distress Syndrome (ARDS) due to coronavirus 2019 (COVID-19). Only a few data describe the maximum time under VV-ECMO during which pulmonary recovery remains possible. The main objective of this study is to describe the outcomes of prolonged VV-ECMO in patients with COVID-19-related ARDS.

Methods

This retrospective study was conducted at a tertiary ECMO center in Brussels, Belgium, between March 2020 and April 2022. All adult patients with ARDS due to COVID-19 who were managed with ECMO therapy for more than 50 days as a bridge to recovery were included.

Results

Fourteen patients met the inclusion criteria. The mean duration of VV-ECMO was 87 ± 29 days. Ten (71%) patients were discharged alive from the hospital. The 90-day survival was 86%, and the one-year survival was 71%. The evolution of the patients was characterized by very impaired pulmonary compliance that started to improve slowly and progressively on day 53 (± 25) after the start of ECMO. Of note, four patients improved substantially after a second course of steroids.

Conclusions

There is potential for recovery in patients with very severe ARDS due to COVID-19 supported by VV-ECMO for up to 151 days.

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Title: Potential for recovery after extremely prolonged VV-ECMO support in well-selected severe COVID-19 patients: a retrospective cohort study
Authors: Jean-Marc de Walque
Christophe de Terwangne
Raphaël Jungers
Sophie Pierard
Christophe Beauloye
Fatima Laarbaui
Melanie Dechamps
Luc Marie Jacquet
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: ECMO
ECMO
Acute Respiratory Distress-Syndrome
COVID-19
Published in: BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI: https://doi.org/10.1186/s12890-023-02836-3

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