Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus
Identifieur interne : 001D07 ( Ncbi/Checkpoint ); précédent : 001D06; suivant : 001D08Extracorporeal 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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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. The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV.</p>
</sec>
</div>
</front>
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<author><name sortKey="Mastroianni, C" uniqKey="Mastroianni C">C Mastroianni</name>
</author>
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<author><name sortKey="Combes, A" uniqKey="Combes A">A Combes</name>
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<author><name sortKey="Ujayli, A" uniqKey="Ujayli A">A Ujayli</name>
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<author><name sortKey="Ghabashi, A" uniqKey="Ghabashi A">A Ghabashi</name>
</author>
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<author><name sortKey="Arcadipane, A" uniqKey="Arcadipane A">A Arcadipane</name>
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<author><name sortKey="Davis, Mm" uniqKey="Davis M">MM Davis</name>
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<name sortKey="Zein, Ahmed" sort="Zein, Ahmed" uniqKey="Zein A" first="Ahmed" last="Zein">Ahmed Zein</name>
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<country name="Égypte"><noRegion><name sortKey="Abdelzaher, Mohammed" sort="Abdelzaher, Mohammed" uniqKey="Abdelzaher M" first="Mohammed" last="Abdelzaher">Mohammed Abdelzaher</name>
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