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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2018

Open Access 01-12-2018 | Research

Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus

Authors: Mohammed S. Alshahrani, Anees Sindi, Fayez Alshamsi, Awad Al-Omari, Mohamed El Tahan, Bayan Alahmadi, Ahmed Zein, Naif Khatani, Fahad Al-Hameed, Sultan Alamri, Mohammed Abdelzaher, Amenah Alghamdi, Faisal Alfousan, Adel Tash, Wail Tashkandi, Rajaa Alraddadi, Kim Lewis, Mohammed Badawee, Yaseen M. Arabi, Eddy Fan, Waleed Alhazzani

Published in: Annals of Intensive Care | Issue 1/2018

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Abstract

Background

Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS‐CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies.

Methods

We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia. Patients were classified into two groups: ECMO versus conventional therapy. Our primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay.

Results

Thirty-five patients were included; 17 received ECMO and 18 received conventional therapy. Both groups had similar baseline characteristics. The ECMO group had lower in-hospital mortality (65 vs. 100%, P = 0.02), longer ICU stay (median 25 vs. 8 days, respectively, P < 0.01), and similar hospital stay (median 41 vs. 31 days, P = 0.421). In addition, patients in the ECMO group had better PaO2/FiO2 at days 7 and 14 of admission to the ICU (124 vs. 63, and 138 vs. 36, P < 0.05), and less use of norepinephrine at days 1 and 14 (29 vs. 80%; and 36 vs. 93%, P < 0.05).

Conclusions

ECMO use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV.
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Metadata
Title
Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus
Authors
Mohammed S. Alshahrani
Anees Sindi
Fayez Alshamsi
Awad Al-Omari
Mohamed El Tahan
Bayan Alahmadi
Ahmed Zein
Naif Khatani
Fahad Al-Hameed
Sultan Alamri
Mohammed Abdelzaher
Amenah Alghamdi
Faisal Alfousan
Adel Tash
Wail Tashkandi
Rajaa Alraddadi
Kim Lewis
Mohammed Badawee
Yaseen M. Arabi
Eddy Fan
Waleed Alhazzani
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2018
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0350-x

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