Effect of Respiratory Support Type and Total Duration on Weaning From Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Patients.

Background: We evaluated the impact of noninvasive respiratory support (NRS) and invasive mechanical ventilation duration before venovenous extracorporeal membrane oxygenation (VV-ECMO) on weaning from venovenous ECMO and survival. Methods: In a retrospective single-center study, we studied subjects...

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Publicado en:Respiratory Care Vol. 70; no. 9; pp. 1140 - 1148
Autores principales: Marabotti, Alberto, Cianchi, Giovanni, Pelagatti, Filippo, Ciapetti, Marco, Franci, Andrea, Socci, Filippo, Fulceri, Giorgio Enzo, Lazzeri, Chiara, Bonizzoli, Manuela, Peris, Adriano
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
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      pub: Mary Ann Liebert, Inc.
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        10.1089/respcare.12246
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        atl: Effect of Respiratory Support Type and Total Duration on Weaning From Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Patients.
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        au:
          Marabotti, Alberto
          Cianchi, Giovanni
          Pelagatti, Filippo
          Ciapetti, Marco
          Franci, Andrea
          Socci, Filippo
          Fulceri, Giorgio Enzo
          Lazzeri, Chiara
          Bonizzoli, Manuela
          Peris, Adriano
        affil: Drs. Marabotti, Cianchi, Ciapetti, Franci, Socci, Fulceri, Lazzeri, Bonizzoli, and Peris are affiliated with Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
      sug:
        subj:
          Extracorporeal Membrane Oxygenation
          COVID-19 Psychosocial Factors
          Respiratory Distress Syndrome, Acute
          Invasive Procedures
          Noninvasive Procedures
          Respiration, Artificial
          Treatment Outcomes
          Human
          Male
          Female
          Adult
          Middle Age
          Retrospective Design
          Record Review
          ROC Curve
          T-Tests
          Mann-Whitney U Test
          Financial Information Systems
          Fisher's Exact Test
          Survival Analysis
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: We evaluated the impact of noninvasive respiratory support (NRS) and invasive mechanical ventilation duration before venovenous extracorporeal membrane oxygenation (VV-ECMO) on weaning from venovenous ECMO and survival. Methods: In a retrospective single-center study, we studied subjects with COVID-19 ARDS treated with VV-ECMO. The subjects were divided and analyzed according to the cut-off of NRS, invasive ventilation, and total duration of respiratory support. Results: We identified a cut-off of NRS duration of 4 days, invasive ventilation duration of 5 days, and total respiratory support duration of 8 days. Weaning from VV-ECMO was observed in 63% (15/24) of subjects with NRS duration ≤ 4 days and in 16% (4/25) of subjects with NRS > 4 days (P =.001), in 50% (17/34) of subjects with invasive ventilation duration ≤ 5 days, in 13% (2/15) of subjects with invasive ventilation duration > 5 days (P =.02), in 68% (13/19) of subjects with total support duration < 8 days, and in 20% (6/30) of subjects with total support duration > 8 days (P =.001). The survival probability at 200 days demonstrated a statistically significant difference in NRS and total support duration comparison (P =.001 and P =.004, respectively). We did not find a statistically significant survival difference according to invasive ventilation duration (P =.13). Conclusions: In our population, the increase in NRS and total support days before ECMO could hamper weaning from VV-ECMO support. However, due to the pandemic, the small sample size, and the lack of precise data on ventilation settings, caution should be exercised in universalizing these results.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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