Thorac Cardiovasc Surg 2023; 71(S 01): S1-S72
DOI: 10.1055/s-0043-1761782
Monday, 13 February
Therapie Kreislaufunterstützung: Neue Perspektiven

Life Beyond ECMO: A Six-Month Follow-Up After ECMO Support for Therapy-Refractive ARDS in Case of SARS-CoV-2 Infection

V. H. Hettlich
1   Department of Cardiac Surgery, Heinrich-Heine University, Duesseldorf, Deutschland
,
M. B. Immohr
2   Universitätsklinikum Aachen Klinik für Thorax- und Herzchirurgie, Aachen, Deutschland
,
T. Brandenburger
3   Department of Anesthesiology, Heinrich-Heine University, Duesseldorf, Deutschland
,
D. Kindgen-Milles
3   Department of Anesthesiology, Heinrich-Heine University, Duesseldorf, Deutschland
,
T. Feldt
4   Department of Gastroenterology, Hepatology and Infekliology, Heinrich-Heine University, Düsseldorf, Deutschland
,
P. Akhyari
2   Universitätsklinikum Aachen Klinik für Thorax- und Herzchirurgie, Aachen, Deutschland
,
T. Igor
1   Department of Cardiac Surgery, Heinrich-Heine University, Duesseldorf, Deutschland
,
H. Aubin
1   Department of Cardiac Surgery, Heinrich-Heine University, Duesseldorf, Deutschland
,
H. Dalyanoglu
1   Department of Cardiac Surgery, Heinrich-Heine University, Duesseldorf, Deutschland
,
A. Lichtenberg
1   Department of Cardiac Surgery, Heinrich-Heine University, Duesseldorf, Deutschland
,
U. Boeken
1   Department of Cardiac Surgery, Heinrich-Heine University, Duesseldorf, Deutschland
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Background: With progression of the COVID-19 pandemic the veno-venous ECMO therapy as an ultima ratio is gaining a new value by the increasing number of patients with therapy refractive ARDS. This study aims to observe the prognoses and the long-term complications following ECMO to improve therapy options and patient satisfaction.

Method: In the period between March 2020 and February 2022, a total of 98 patients were treated with vv-ECMO in case of a COVID-19-related ARDS in our center. Demographic and health-specific parameters of all patients were recorded in a database. In addition, the patients were followed up via a telephonic consultation 6 months after discharge from the hospital. Data were retrospectively analyzed.

Results: Of all treated patients, 29 survived the hospital stay. After a period of 6 months following discharge, 28 (97%) of these patients were still alive. The results showed that almost all of them (n = 27) still did not completely recover by the time of follow-up. Eighteen (64%) of the patients were still suffering from persistent dyspnea and 13 (46%) were still under ongoing respiratory rehabilitation. However, none of the patients was still in stationary hospital treatment or under mechanical ventilation therapy, but 6 (21%) patients still required O2 therapy at their home and 12 (43%) still suffered from cognitive problems. Because of the mentioned long-term effects, among other things, at that point only 6 patients were possible to return to their working life. With regard to patients’ gender, we found persistent dyspnea in 83% of female and only in 50% of male patients. Cognitive problems were obvious in 58% of the women and in 31% of men.

Conclusion: The majority of patients surviving ECMO therapy based on a COVID-19 infection suffered from long-term limitations. In our follow-up, female patients showed a higher incidence of long-term consequences than male patients. Since we are still in an early stage of research about the virus, it remains important to determine short-term as well as long-term effects of therapy options to optimize the outcome.



Publication History

Article published online:
28 January 2023

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