Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus
Identifieur interne : 000973 ( Main/Exploration ); précédent : 000972; suivant : 000974Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus
Auteurs : Mohammed S. Alshahrani [Arabie saoudite] ; Anees Sindi [Arabie saoudite] ; Fayez Alshamsi ; Awad Al-Omari [Arabie saoudite] ; Mohamed El Tahan [Arabie saoudite] ; Bayan Alahmadi [Arabie saoudite] ; Ahmed Zein [Arabie saoudite] ; Naif Khatani [Arabie saoudite] ; Fahad Al-Hameed [Arabie saoudite] ; Sultan Alamri [Arabie saoudite] ; Mohammed Abdelzaher [Égypte] ; Amenah Alghamdi [Arabie saoudite] ; Faisal Alfousan [Arabie saoudite] ; Adel Tash [Arabie saoudite] ; Wail Tashkandi [Arabie saoudite] ; Rajaa Alraddadi [Arabie saoudite] ; Kim Lewis [Canada] ; Mohammed Badawee [Arabie saoudite] ; Yaseen M. Arabi [Arabie saoudite] ; Eddy Fan [Canada] ; Waleed Alhazzani [Canada]Source :
- Annals of Intensive Care [ 2110-5820 ] ; 2018.
Abstract
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.
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.
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%,
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.
Url:
DOI: 10.1186/s13613-017-0350-x
PubMed: 29330690
PubMed Central: 5768582
Affiliations:
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institution-id-type="GRID">grid.415296.d</institution-id><institution>Department of ICU,</institution><institution>King Fahad Hospital,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Khatani, Naif" sort="Khatani, Naif" uniqKey="Khatani N" first="Naif" last="Khatani">Naif Khatani</name><affiliation wicri:level="1"><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Al Hameed, Fahad" sort="Al Hameed, Fahad" uniqKey="Al Hameed F" first="Fahad" last="Al-Hameed">Fahad Al-Hameed</name><affiliation wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0607 2419</institution-id><institution-id institution-id-type="GRID">grid.416641.0</institution-id><institution>King Abdulaziz Medical City,</institution><institution>NGHA,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff9"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0608 0662</institution-id><institution-id institution-id-type="GRID">grid.412149.b</institution-id><institution>Intensive Care Department,</institution><institution>King Saud bin Abdulaziz University for Health Sciences,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Alamri, Sultan" sort="Alamri, Sultan" uniqKey="Alamri S" first="Sultan" last="Alamri">Sultan Alamri</name><affiliation wicri:level="1"><nlm:aff id="Aff10">Department of ICU National Hospital, Internal Medicine and Critical Care, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of ICU National Hospital, Internal Medicine and Critical Care, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Abdelzaher, Mohammed" sort="Abdelzaher, Mohammed" uniqKey="Abdelzaher M" first="Mohammed" last="Abdelzaher">Mohammed Abdelzaher</name><affiliation wicri:level="1"><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="GRID">grid.476980.4</institution-id><institution>Critical Care Medicine Department,</institution><institution>Cairo University Hospitals,</institution></institution-wrap>Cairo, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Cairo</wicri:regionArea></affiliation></author><author><name sortKey="Alghamdi, Amenah" sort="Alghamdi, Amenah" uniqKey="Alghamdi A" first="Amenah" last="Alghamdi">Amenah Alghamdi</name><affiliation wicri:level="1"><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>Department of Internal Medicine,</institution><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Alfousan, Faisal" sort="Alfousan, Faisal" uniqKey="Alfousan F" first="Faisal" last="Alfousan">Faisal Alfousan</name><affiliation wicri:level="1"><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>Department of Internal Medicine,</institution><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Tash, Adel" sort="Tash, Adel" uniqKey="Tash A" first="Adel" last="Tash">Adel Tash</name><affiliation wicri:level="1"><nlm:aff id="Aff13"><institution-wrap><institution-id institution-id-type="GRID">grid.498593.a</institution-id><institution-id institution-id-type="ISNI">0000 0004 0427 1086</institution-id><institution>Department of Cardiac Surgery,</institution><institution>King Abdullah Medical City,</institution></institution-wrap>Makkah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Makkah</wicri:regionArea></affiliation></author><author><name sortKey="Tashkandi, Wail" sort="Tashkandi, Wail" uniqKey="Tashkandi W" first="Wail" last="Tashkandi">Wail Tashkandi</name><affiliation wicri:level="1"><nlm:aff id="Aff14"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>Department of Surgery/Intensive Care,</institution><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Alraddadi, Rajaa" sort="Alraddadi, Rajaa" uniqKey="Alraddadi R" first="Rajaa" last="Alraddadi">Rajaa Alraddadi</name><affiliation wicri:level="1"><nlm:aff id="Aff15"><institution-wrap><institution-id institution-id-type="GRID">grid.415696.9</institution-id><institution>Community Medicine Department,</institution><institution>Ministry of Health,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Jeddah</wicri:regionArea></affiliation></author><author><name sortKey="Lewis, Kim" sort="Lewis, Kim" uniqKey="Lewis K" first="Kim" last="Lewis">Kim Lewis</name><affiliation wicri:level="1"><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8227</institution-id><institution-id institution-id-type="GRID">grid.25073.33</institution-id><institution>Department of Medicine, Division of Critical Care,</institution><institution>McMaster University,</institution></institution-wrap>Hamilton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Hamilton</wicri:regionArea></affiliation></author><author><name sortKey="Badawee, Mohammed" sort="Badawee, Mohammed" uniqKey="Badawee M" first="Mohammed" last="Badawee">Mohammed Badawee</name><affiliation wicri:level="1"><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9759 8141</institution-id><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution>Department of Critical Care,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><affiliation wicri:level="1"><nlm:aff id="Aff18"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0608 0662</institution-id><institution-id institution-id-type="GRID">grid.412149.b</institution-id><institution>King Abdullah International Medical Research Center,</institution><institution>King Saud bin Abdulaziz University for Health Sciences,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Fan, Eddy" sort="Fan, Eddy" uniqKey="Fan E" first="Eddy" last="Fan">Eddy Fan</name><affiliation wicri:level="1"><nlm:aff id="Aff19"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2157 2938</institution-id><institution-id institution-id-type="GRID">grid.17063.33</institution-id><institution>Interdepartmental Division of Critical Care Medicine,</institution><institution>University of Toronto,</institution></institution-wrap>Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto</wicri:regionArea></affiliation></author><author><name sortKey="Alhazzani, Waleed" sort="Alhazzani, Waleed" uniqKey="Alhazzani W" first="Waleed" last="Alhazzani">Waleed Alhazzani</name><affiliation wicri:level="1"><nlm:aff id="Aff20"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8227</institution-id><institution-id institution-id-type="GRID">grid.25073.33</institution-id><institution>Department of Clinical Epidemiology and Biostatistics,</institution><institution>McMaster University,</institution></institution-wrap>Hamilton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Hamilton</wicri:regionArea></affiliation></author></analytic><series><title level="j">Annals of Intensive Care</title><idno type="eISSN">2110-5820</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">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.</p></sec><sec><title>Methods</title><p id="Par2">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.</p></sec><sec><title>Results</title><p id="Par3">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%, <italic>P</italic> = 0.02), longer ICU stay (median 25 vs. 8 days, respectively, <italic>P</italic> < 0.01), and similar hospital stay (median 41 vs. 31 days, <italic>P</italic> = 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, <italic>P</italic> < 0.05), and less use of norepinephrine at days 1 and 14 (29 vs. 80%; and 36 vs. 93%, <italic>P</italic> < 0.05).</p></sec><sec><title>Conclusions</title><p id="Par4">ECMO use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. 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Arifi</name></author><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Najm, H" uniqKey="Najm H">H Najm</name></author><author><name sortKey="Aldawood, As" uniqKey="Aldawood A">AS Aldawood</name></author><author><name sortKey="Ghabashi, A" uniqKey="Ghabashi A">A Ghabashi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name></author><author><name sortKey="Al Rabeeah, Aa" uniqKey="Al Rabeeah A">AA Al-Rabeeah</name></author><author><name sortKey="Al Rabiah, Fa" uniqKey="Al Rabiah F">FA Al-Rabiah</name></author><author><name sortKey="Al Hajjar, S" uniqKey="Al Hajjar S">S Al-Hajjar</name></author><author><name sortKey="Al Barrak, A" uniqKey="Al Barrak A">A Al-Barrak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author><author><name sortKey="Perl, Tm" uniqKey="Perl T">TM Perl</name></author><author><name sortKey="Price, Cs" uniqKey="Price C">CS Price</name></author><author><name sortKey="Al Rabeeah, Aa" uniqKey="Al Rabeeah A">AA Al Rabeeah</name></author><author><name sortKey="Cummings, Da" uniqKey="Cummings D">DA Cummings</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pappalardo, F" uniqKey="Pappalardo F">F Pappalardo</name></author><author><name sortKey="Pieri, M" uniqKey="Pieri M">M Pieri</name></author><author><name sortKey="Greco, T" uniqKey="Greco T">T Greco</name></author><author><name sortKey="Patroniti, N" uniqKey="Patroniti N">N Patroniti</name></author><author><name sortKey="Pesenti, A" uniqKey="Pesenti A">A Pesenti</name></author><author><name sortKey="Arcadipane, A" uniqKey="Arcadipane A">A Arcadipane</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barbaro, Rp" uniqKey="Barbaro R">RP Barbaro</name></author><author><name sortKey="Odetola, Fo" uniqKey="Odetola F">FO Odetola</name></author><author><name sortKey="Kidwell, Km" uniqKey="Kidwell K">KM Kidwell</name></author><author><name sortKey="Paden, Ml" uniqKey="Paden M">ML Paden</name></author><author><name sortKey="Bartlett, Rh" uniqKey="Bartlett R">RH Bartlett</name></author><author><name sortKey="Davis, Mm" uniqKey="Davis M">MM Davis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name></author><author><name sortKey="Momattin, H" uniqKey="Momattin H">H Momattin</name></author><author><name sortKey="Dib, J" uniqKey="Dib J">J Dib</name></author><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Omrani, As" uniqKey="Omrani A">AS Omrani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shalboub, S" uniqKey="Shalboub S">S Shalboub</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Von Elm, E" uniqKey="Von Elm E">E Von Elm</name></author><author><name sortKey="Altman, Dg" uniqKey="Altman D">DG Altman</name></author><author><name sortKey="Egger, M" uniqKey="Egger M">M Egger</name></author><author><name sortKey="Pocock, Sj" uniqKey="Pocock S">SJ Pocock</name></author><author><name sortKey="Gotzsche, Pc" uniqKey="Gotzsche P">PC Gotzsche</name></author><author><name sortKey="Vandenbroucke, Jp" uniqKey="Vandenbroucke J">JP Vandenbroucke</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Arabie saoudite</li><li>Canada</li><li>Égypte</li></country></list><tree><noCountry><name sortKey="Alshamsi, Fayez" sort="Alshamsi, Fayez" uniqKey="Alshamsi F" first="Fayez" last="Alshamsi">Fayez Alshamsi</name></noCountry><country name="Arabie saoudite"><noRegion><name sortKey="Alshahrani, Mohammed S" sort="Alshahrani, Mohammed S" uniqKey="Alshahrani M" first="Mohammed S." last="Alshahrani">Mohammed S. Alshahrani</name></noRegion><name sortKey="Al Hameed, Fahad" sort="Al Hameed, Fahad" uniqKey="Al Hameed F" first="Fahad" last="Al-Hameed">Fahad Al-Hameed</name><name sortKey="Al Hameed, Fahad" sort="Al Hameed, Fahad" uniqKey="Al Hameed F" first="Fahad" last="Al-Hameed">Fahad Al-Hameed</name><name sortKey="Al Omari, Awad" sort="Al Omari, Awad" uniqKey="Al Omari A" first="Awad" last="Al-Omari">Awad Al-Omari</name><name sortKey="Alahmadi, Bayan" sort="Alahmadi, Bayan" uniqKey="Alahmadi B" first="Bayan" last="Alahmadi">Bayan Alahmadi</name><name sortKey="Alamri, Sultan" sort="Alamri, Sultan" uniqKey="Alamri S" first="Sultan" last="Alamri">Sultan Alamri</name><name sortKey="Alfousan, Faisal" sort="Alfousan, Faisal" uniqKey="Alfousan F" first="Faisal" last="Alfousan">Faisal Alfousan</name><name sortKey="Alghamdi, Amenah" sort="Alghamdi, Amenah" uniqKey="Alghamdi A" first="Amenah" last="Alghamdi">Amenah Alghamdi</name><name sortKey="Alraddadi, Rajaa" sort="Alraddadi, Rajaa" uniqKey="Alraddadi R" first="Rajaa" last="Alraddadi">Rajaa Alraddadi</name><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><name sortKey="Badawee, Mohammed" sort="Badawee, Mohammed" uniqKey="Badawee M" first="Mohammed" last="Badawee">Mohammed Badawee</name><name sortKey="El Tahan, Mohamed" sort="El Tahan, Mohamed" uniqKey="El Tahan M" first="Mohamed" last="El Tahan">Mohamed El Tahan</name><name sortKey="Khatani, Naif" sort="Khatani, Naif" uniqKey="Khatani N" first="Naif" last="Khatani">Naif Khatani</name><name sortKey="Sindi, Anees" sort="Sindi, Anees" uniqKey="Sindi A" first="Anees" last="Sindi">Anees Sindi</name><name sortKey="Tash, Adel" sort="Tash, Adel" uniqKey="Tash A" first="Adel" last="Tash">Adel Tash</name><name sortKey="Tashkandi, Wail" sort="Tashkandi, Wail" uniqKey="Tashkandi W" first="Wail" last="Tashkandi">Wail Tashkandi</name><name sortKey="Zein, Ahmed" sort="Zein, Ahmed" uniqKey="Zein A" first="Ahmed" last="Zein">Ahmed Zein</name></country><country name="Égypte"><noRegion><name sortKey="Abdelzaher, Mohammed" sort="Abdelzaher, Mohammed" uniqKey="Abdelzaher M" first="Mohammed" last="Abdelzaher">Mohammed Abdelzaher</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Lewis, Kim" sort="Lewis, Kim" uniqKey="Lewis K" first="Kim" last="Lewis">Kim Lewis</name></noRegion><name sortKey="Alhazzani, Waleed" sort="Alhazzani, Waleed" uniqKey="Alhazzani W" first="Waleed" last="Alhazzani">Waleed Alhazzani</name><name sortKey="Fan, Eddy" sort="Fan, Eddy" uniqKey="Fan E" first="Eddy" last="Fan">Eddy Fan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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