Echocardiography Before Extracorporeal Membrane Oxygenation in Refractory Respiratory Failure: SARS-CoV-2 Infection Versus Other Etiologies
Authors' conclusion
The presence of RV dilatation and an altered coupling between RVe function and pulmonary vasculature (as indicated by TAPSE and/or sPAP) are associated strictly with COVID-19-related refractory respiratory failure needing ECMO support.
Study context
- Population
- Intensive care unit (ICU) patients with refractory respiratory failure needing extracorporeal membrane oxygenation (ECMO) support, echocardiogram just before ECMO implantation
- Participants
- 61 vs 74
- Exposure
- COVID-19 series vs no COVID-19 series
- COVID-19 seriesn = 61
- No COVID-19 seriesn = 74reference
- Outcome
- Pre-ECMO echocardiographic findings (RV dilatation and dysfunction; RV end-diastolic area/LVEDA >0.6 and TAPSE <15 mm)
- Follow-up
- Just before ECMO implantation
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Pre-ECMO echocardiographic findings
- Incidence of RV dilatation higher in COVID-19 series
- p < 0.001
- Higher systolic pulmonary artery pressure (sPAP) in COVID-19 series
- p < 0.001
- Lower TAPSE and/or sPAP in COVID-19 series
- p < 0.001
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Higher BMI in COVID-19 series
- P < 0.001
- Lower SOFA score in COVID-19 series
- P = 0.002
In-ICU mortality
- Comparable between the 2 subgroups
Early mortality (multivariate logistic regression)
- COVID-19-related respiratory failure not associated with early mortality
Original publication
Echocardiography Before Extracorporeal Membrane Oxygenation in Refractory Respiratory Failure: SARS-CoV-2 Infection Versus Other Etiologies. J Cardiothorac Vasc Anesth. Published 14 March 2023. doi:10.
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