Evidence map›Paper›PMID 35348610›Full record

ArticleAnesthesiology2022

Extracorporeal Membrane Oxygenation for Respiratory Failure Related to COVID-19: A Nationwide Cohort Study.

Nicolas Nesseler, Guillaume Fadel, Alexandre Mansour, Marylou Para, Pierre-Emmanuel Falcoz, Nicolas Mongardon, Alizée Porto, Astrid Bertier, Bruno Levy, Cyril Cadoz and 19 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors at 20 institutions in 2 countries.

Nicolas NesselerDepartment of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, France; University of Rennes, University Hospital of Rennes, National Institute of Health and Medical Research, Center of Clinical Investigation of Rennes 1414, Rennes, France; University of Rennes, University Hospital of Rennes, National Research Institute for Agriculture, National Institute of Health and Medical Research, Institute of Nutrition, Metabolism, and Cancer, Mixed Research Unit_1341, Mixed Research Unit_1241, Rennes, France.
Guillaume FadelSorbonne University, National Institute of Health and Medical Research, Mixed Research Unit_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France; Department of Thoracic and Cardiovascular, Cardiology Institute, Public Assistance-Hospitals of Paris, Sorbonne University, Pitié-Salpétriêre Hospital, Paris, France.
Alexandre MansourDepartment of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Rennes, France; University of Rennes, University Hospital of Rennes, National Institute of Health and Medical Research, Center of Clinical Investigation of Rennes 1414, Rennes, France.
Marylou ParaDepartment of Cardiovascular Surgery and Transplantation, Bichat Hospital, Public Assistance-Hospitals of Paris, Paris, France; University of Paris, Mixed Research Unit_1148, Laboratory of Vascular Translational Science, Paris, France.
Pierre-Emmanuel FalcozNational Institute of Health and Medical Research, Mixed Research Unit_1260, Regenerative Nanomedicine, Translational Medicine Federation, Strasbourg, France; University of Strasbourg, Pharmacy and Medical School, Strasbourg, France; University Hospital of Strasbourg, Thoracic Surgery Department, New Hospital Civil, Strasbourg, France.
Nicolas MongardonDepartment of Anesthesia and Critical Care, Medical-University Department, Surgery, Anesthesiology, Surgical Intensive Care Units, University Hospital Department Ageing Thorax-Vessels-Blood, Public Assistance-Hospitals of Paris, Henri Mondor University Hospitals, Créteil, France; University of East Paris Créteil, School of Medicine, Créteil, France; U955-Mondor Institute of Biomedical Research, Equipe 03, Pharmacology and Technologies for Cardiovascular Diseases, National Institute of Health and Medical Research, University of East Paris Créteil, National Veterinary School of Alfort, Maisons-Alfort, France.
Alizée PortoDepartment of Cardiac Surgery, Timone Hospital, Marseille Public University Hospital System, 13005, Marseille, France.
Astrid BertierIntensive Care Unit, Bicêtre Hospital, Public Assistance-Hospitals of Paris, Paris, France.
Bruno LevyIntensive Care Unit, CHRU Nancy, Pôle Cardio-Médico-Chirurgical, Vandœuvre-lès-Nancy, France; National Institute of Health and Medical Research U1116, Faculty of Medicine, Vandoeuvre-lès-Nancy, France; University of Lorraine, Nancy, France.
Cyril CadozPolyvalent Intensive Care Unit, Mercy Hospital, Regional Hospital, Metz-Thionville, France.
Pierre-Grégoire GuinotDepartment of Anesthesiology and Critical Care Medicine, Dijon University Hospital, Dijon, France.
Olivier FouquetDepartment of Thoracic and Cardiovascular Surgery, University Hospital, Angers, France; Mitochondrial and Cardiovascular Pathophysiology Institute, French National Centre for Scientific Research, Mixed Research Unit_6214, National Institute of Health and Medical Research U1083, University of Angers, Angers, France.
Jean-Luc FellahiDepartment of Anesthesia and Critical Care, Louis Pradel Hospital, University Hospital of Lyon, Lyon, France; CarMeN Laboratory, National Institute of Health and Medical Research, Mixed Research Unit_1060, Claude Bernard Lyon University, Lyon, France.
Alexandre OuattaraUniversity Hospital of Bordeaux, Department of Anesthesia and Critical Care, Magellan Medico-Surgical Center, Bordeaux, France; National Institute of Health and Medical Research, Mixed Research Unit 1034, Biology of Cardiovascular Diseases, Pessac, France.
Julien GuihaireDepartment of Cardiac Surgery, National Institute of Health and Medical Research, Mixed Research Unit_999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Marie Lannelongue Hospital, Paris Saint-Joseph Hospital Group, University of Paris-Saclay School of Medicine, Le Plessis Robinson, France.
Vito-Giovanni RuggieriDivision of Cardiothoracic and Vascular Surgery, Robert Debré University Hospital, University of Reims Champagne-Ardenne, Reims, France.
Philippe GaudardDepartment of Anesthesia and Critical Care, PhyMedExp, Montpellier University, National Institute of Health and Medical Research, French National Centre for Scientific Research, University Hospital of Montpellier, Montpellier, France.
François LabasteAnesthesiology and Intensive Care Department, University Hospital of Toulouse, Toulouse, France; Metabolic and Cardiovascular Diseases Institute, National Institute of Health and Medical Research U1048, University of Toulouse, Paul Sabatier University, Toulouse, France.
Thomas ClavierDepartment of Anesthesiology, Critical Care and Perioperative Medicine, University Hospital of Rouen, Rouen, France.
Kais BriniPolyvalent and Cardiac Intensive Care Unit, Montsouris Mutualist Institute, Paris, France.
Nicolas AllouPolyvalent Intensive Care Unit, Félix Guyon-Saint-Denis University Hospital, La Réunion, Saint Denis, France.
Corentin LacroixDepartment of Cardiothoracic Surgery, University Hospital of Poitiers, Poitiers, France.
Juliette ChommelouxSorbonne University, National Institute of Health and Medical Research, Mixed Research Unit_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France; Intensive Care Unit, Cardiology Unit, Public Assistance-Hospitals of Paris, Sorbonne University, La Pitié-Salpêtrière Hospital, Paris, France.
Guillaume LebretonSorbonne Université, University, National Institute of Health and Medical Research, Mixed Research Unit_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France; Department of Thoracic and Cardiovascular Surgery, Cardiology Institute, Public Assistance-Hospitals of Paris, Sorbonne University, La Pitié-Salpêtrière Hospital, Paris, France.
Michael A MatthayDepartments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California.
Sophie ProvenchereUniversity of Paris, Department of Anesthesiology and Intensive Care, Public Assistance-Hospitals of Paris, Bichat-Claude Bernard Hospital, Paris, France; Clinical Investigation Center 1425, Public Assistance-Hospitals of Paris, National Institute of Health and Medical Research, Paris, France.
Erwan FlécherDepartment of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, University of Rennes 1, Signal and Image Treatment Laboratory, National Institute of Health and Medical Research U1099, Rennes, France.
André VincentelliDepartment of Cardiac Surgery, University Hospital of Lille, Lille, France.
ECMOSARS Investigators
Sorbonne Université · FRHôpital Pontchaillou · FRUniversité Claude Bernard Lyon 1 · FRAssistance Publique Hôpitaux de Marseille · FRBicêtre Hospital · FRCentre Hospitalier Universitaire de La Réunion · FRCentre Hospitalier Universitaire de Rennes · FRInstitute Mutualiste Montsouris · FRLaboratoire de Recherche Vasculaire Translationnelle · FRMaison des Sciences sociales et des Humanités de Dijon · FRMercy Medical Center · USRegenerative NanoMedicine · FRUniversité d'Angers · FRUniversité de Bordeaux · FRUniversité de Lille · FRUniversité de Lorraine · FRUniversité de Montpellier · FRUniversité de Poitiers · FRUniversité de Reims Champagne-Ardenne · FRUniversité de Rouen Normandie · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite expanding use, knowledge on extracorporeal membrane oxygenation support during the COVID-19 pandemic remains limited. The objective was to report characteristics, management, and outcomes of patients receiving extracorporeal membrane oxygenation with a diagnosis of COVID-19 in France and to identify pre-extracorporeal membrane oxygenation factors associated with in-hospital mortality. A hypothesis of similar mortality rates and risk factors for COVID-19 and non-COVID-19 patients on venovenous extracorporeal membrane oxygenation was made.

methodsThe Extracorporeal Membrane Oxygenation for Respiratory Failure and/or Heart failure related to Severe Acute Respiratory Syndrome-Coronavirus 2 (ECMOSARS) registry included COVID-19 patients supported by extracorporeal membrane oxygenation in France. This study analyzed patients included in this registry up to October 25, 2020, and supported by venovenous extracorporeal membrane oxygenation for respiratory failure with a minimum follow-up of 28 days after cannulation. The primary outcome was in-hospital mortality. Risk factors for in-hospital mortality were analyzed.

resultsAmong 494 extracorporeal membrane oxygenation patients included in the registry, 429 were initially supported by venovenous extracorporeal membrane oxygenation and followed for at least 28 days. The median (interquartile range) age was 54 yr (46 to 60 yr), and 338 of 429 (79%) were men. Management before extracorporeal membrane oxygenation cannulation included prone positioning for 411 of 429 (96%), neuromuscular blockage for 419 of 427 (98%), and NO for 161 of 401 (40%). A total of 192 of 429 (45%) patients were cannulated by a mobile extracorporeal membrane oxygenation unit. In-hospital mortality was 219 of 429 (51%), with a median follow-up of 49 days (33 to 70 days). Among pre-extracorporeal membrane oxygenation modifiable exposure variables, neuromuscular blockage use (hazard ratio, 0.286; 95% CI, 0.101 to 0.81) and duration of ventilation (more than 7 days compared to less than 2 days; hazard ratio, 1.74; 95% CI, 1.07 to 2.83) were independently associated with in-hospital mortality. Both age (per 10-yr increase; hazard ratio, 1.27; 95% CI, 1.07 to 1.50) and total bilirubin at cannulation (6.0 mg/dl or more compared to less than 1.2 mg/dl; hazard ratio, 2.65; 95% CI, 1.09 to 6.5) were confounders significantly associated with in-hospital mortality.

conclusionsIn-hospital mortality was higher than recently reported, but nearly half of the patients survived. A high proportion of patients were cannulated by a mobile extracorporeal membrane oxygenation unit. Several factors associated with mortality were identified. Venovenous extracorporeal membrane oxygenation support should be considered early within the first week of mechanical ventilation initiation. EDITOR’S PERSPECTIVE:

Indexed as

COVID-19Extracorporeal Membrane OxygenationRespiratory InsufficiencyCohort StudiesHumansMalePandemicsRetrospective Studies

Identifiers

PMID35348610
PMCPMC9006801
OpenAlexW4220849695

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.