Title |
Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus
|
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Published in |
Annals of Intensive Care, January 2018
|
DOI | 10.1186/s13613-017-0350-x |
Pubmed ID | |
Authors |
Mohammed S. Alshahrani, Anees Sindi, Fayez Alshamsi, Awad Al-Omari, Mohamed El Tahan, Bayan Alahmadi, Ahmed Zein, Naif Khatani, Fahad Al-Hameed, Sultan Alamri, Mohammed Abdelzaher, Amenah Alghamdi, Faisal Alfousan, Adel Tash, Wail Tashkandi, Rajaa Alraddadi, Kim Lewis, Mohammed Badawee, Yaseen M. Arabi, Eddy Fan, Waleed Alhazzani |
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%, 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). 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Saudi Arabia | 36 | 40% |
United States | 5 | 6% |
United Kingdom | 3 | 3% |
Canada | 2 | 2% |
Spain | 2 | 2% |
Qatar | 2 | 2% |
Netherlands | 1 | 1% |
Yemen | 1 | 1% |
Australia | 1 | 1% |
Other | 2 | 2% |
Unknown | 35 | 39% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 62 | 69% |
Practitioners (doctors, other healthcare professionals) | 16 | 18% |
Scientists | 12 | 13% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 159 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 32 | 20% |
Other | 18 | 11% |
Student > Master | 16 | 10% |
Student > Bachelor | 14 | 9% |
Student > Postgraduate | 14 | 9% |
Other | 21 | 13% |
Unknown | 44 | 28% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 62 | 39% |
Nursing and Health Professions | 10 | 6% |
Biochemistry, Genetics and Molecular Biology | 6 | 4% |
Computer Science | 5 | 3% |
Agricultural and Biological Sciences | 3 | 2% |
Other | 16 | 10% |
Unknown | 57 | 36% |