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Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus.

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.

journal_name

Ann Intensive Care

journal_title

Annals of intensive care

authors

Alshahrani MS,Sindi A,Alshamsi F,Al-Omari A,El Tahan M,Alahmadi B,Zein A,Khatani N,Al-Hameed F,Alamri S,Abdelzaher M,Alghamdi A,Alfousan F,Tash A,Tashkandi W,Alraddadi R,Lewis K,Badawee M,Arabi YM,Fan E,Alhazzani

doi

10.1186/s13613-017-0350-x

subject

Has Abstract

pub_date

2018-01-10 00:00:00

pages

3

issue

1

issn

2110-5820

pii

10.1186/s13613-017-0350-x

journal_volume

8

pub_type

杂志文章

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