Survival after extracorporeal membrane oxygenation in severe COVID-19 ARDS: results from an international multicenter registry

  1. Supady, Alexander
  2. Taccone, Fabio Silvio
  3. Lepper, Philipp M.
  4. Ziegeler, Stephan
  5. Staudacher, Dawid L.
  6. DellaVolpe, Jeff
  7. Scharpf, Dominik
  8. Ulmer, Matthias
  9. Halbe, Maximilian
  10. Vogt, Alexander
  11. Ramanan, Raj
  12. Boldt, David
  13. Stecher, Stephanie-Susanne
  14. Montisci, Andrea
  15. Spangenberg, Tobias
  16. Marggraf, Olivier
  17. Kunavarapu, Chandra
  18. Peluso, Lorenzo
  19. Muenz, Sebastian
  20. Buerle, Monica
  21. Nagaraj, Naveen G.
  22. Nuding, Sebastian
  23. Toma, Catalin
  24. Gudzenko, Vadim
  25. Stemmler, Hans Joachim
  26. Pappalardo, Federico
  27. Trummer, Georg
  28. Benk, Christoph
  29. Michels, Guido
  30. Bode, Christoph
  31. Duerschmied, Daniel
  32. von zur Muehlen, Constantin
  33. Kaier, Klaus
  34. Brodie, Daniel
  35. Wengenmayer, Tobias

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1000 Titel
  • Survival after extracorporeal membrane oxygenation in severe COVID-19 ARDS: results from an international multicenter registry
1000 Autor/in
  1. Supady, Alexander |
  2. Taccone, Fabio Silvio |
  3. Lepper, Philipp M. |
  4. Ziegeler, Stephan |
  5. Staudacher, Dawid L. |
  6. DellaVolpe, Jeff |
  7. Scharpf, Dominik |
  8. Ulmer, Matthias |
  9. Halbe, Maximilian |
  10. Vogt, Alexander |
  11. Ramanan, Raj |
  12. Boldt, David |
  13. Stecher, Stephanie-Susanne |
  14. Montisci, Andrea |
  15. Spangenberg, Tobias |
  16. Marggraf, Olivier |
  17. Kunavarapu, Chandra |
  18. Peluso, Lorenzo |
  19. Muenz, Sebastian |
  20. Buerle, Monica |
  21. Nagaraj, Naveen G. |
  22. Nuding, Sebastian |
  23. Toma, Catalin |
  24. Gudzenko, Vadim |
  25. Stemmler, Hans Joachim |
  26. Pappalardo, Federico |
  27. Trummer, Georg |
  28. Benk, Christoph |
  29. Michels, Guido |
  30. Bode, Christoph |
  31. Duerschmied, Daniel |
  32. von zur Muehlen, Constantin |
  33. Kaier, Klaus |
  34. Brodie, Daniel |
  35. Wengenmayer, Tobias |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-03-01
1000 Erschienen in
1000 Quellenangabe
  • 25(1):90
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13054-021-03486-9 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919616/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Rhabdomyolysis is frequently occurring in critically ill patients, resulting in a high risk of acute kidney injury (AKI) and potentially permanent kidney damage due to increased myoglobin levels. The extracorporeal elimination of myoglobin might be an approach to prevent AKI, but its molecular weight of 17 kDa complicates an elimination with conventional dialysis membranes. Question of interest is, if myoglobin can be successfully eliminated with the cytokine adsorber Cytosorb® (CS) integrated in a high-flux dialysis system.!##!Methods!#!Patients were included between 10/2014 and 05/2020 in the study population if they had an anuric renal failure with the need of renal replacement therapy, if CS therapy was longer than 90 min and if myoglobin level was > 5.000 ng/ml before treatment. The measurement times of the laboratory values were: d-1 = 24-36 h before CS, d0 = shortly before starting CS and d1 = 12-24 h after starting CS treatment. Statistical analysis were performed with Spearman's correlation coefficient, Wilcoxon test with associated samples and linear regression analysis.!##!Results!#!Forty-three patients were included in the evaluation (median age: 56 years, 77% male patients, 32.6% ECMO therapy, median SAPS II: 80 points and in-hospital mortality: 67%). There was a significant equilateral correlation between creatine kinase (CK) and myoglobin at all measurement points. Furthermore, there was a significant reduction of myoglobin (p = 0.03, 95% confidence interval (CI): - 9030, - 908 ng/ml) during CS treatment, with a median relative reduction of 29%. A higher median reduction of 38% was seen in patients without ongoing rhabdomyolysis (CK decreased during CS treatment, n = 21). In contrast, myoglobin levels did not relevantly change in patients with increasing CK and therefore ongoing rhabdomyolysis (n = 22, median relative reduction 4%). Moreover, there was no significant difference in myoglobin elimination in patients with and without ECMO therapy.!##!Conclusion!#!Blood purification with Cytosorb® during high-flux dialysis led to a significant reduction of myoglobin in patients with severe rhabdomyolysis. The effect might be obscured by sustained rhabdomyolysis, which was seen in patients with rising CK during treatment. Prospective clinical trials would be useful in investigating its benefits in avoiding permanent kidney damage.
1000 Sacherschließung
lokal COVID-19/diagnosis [MeSH]
gnd 1206347392 COVID-19
lokal Female [MeSH]
lokal Extracorporeal Membrane Oxygenation/mortality [MeSH]
lokal Survival Rate/trends [MeSH]
lokal Aged [MeSH]
lokal Humans [MeSH]
lokal Retrospective Studies [MeSH]
lokal Respiratory Distress Syndrome/diagnosis [MeSH]
lokal Middle Aged [MeSH]
lokal Respiratory Distress Syndrome/mortality [MeSH]
lokal COVID-19/therapy [MeSH]
lokal Emergency Medicine
lokal Intensive / Critical Care Medicine
lokal Internationality [MeSH]
lokal COVID-19/mortality [MeSH]
lokal Male [MeSH]
lokal Respiratory Distress Syndrome/therapy [MeSH]
lokal Extracorporeal Membrane Oxygenation/trends [MeSH]
lokal Registries [MeSH]
lokal Research Letter
1000 Liste der Beteiligten
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