TY  - JOUR
A1  - Marx, Gernot
A1  - Schindler, Achim W.
A1  - Mosch, Christoph
A1  - Albers, Joerg
A1  - Bauer, Michael
A1  - Gnass, Irmela
A1  - Hobohm, Carsten
A1  - Janssens, Uwe
A1  - Kluge, Stefan
A1  - Kranke, Peter
A1  - Maurer, Tobias
A1  - Merz, Waltraut
A1  - Neugebauer, Edmund
A1  - Quintel, Michael
A1  - Senninger, Norbert
A1  - Trampisch, Hans-Joachim
A1  - Waydhas, Christian
A1  - Wildenauer, Rene
A1  - Zacharowski, Kai
A1  - Eikermann, Michaela
T1  - Intravascular volume therapy in adults guidelines from the association of the scientific medical societies in Germany
JF  - European Journal of Anaesthesiology
N2  - No abstract available.
KW  - Predict fluid responsiveness
KW  - Randomized controlled-trial
KW  - 6-percent hydroxyethyl starch
KW  - Central venous-pressure
KW  - Elective cesarean-section
KW  - Critically-ill patients
KW  - Puls-pressure variation
KW  - Lactated ringers solution
KW  - Hypertonic saline 7.5-percent
KW  - Major abdominal surgery
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-188223
VL  - 33
IS  - 7
ER  - 
TY  - JOUR
A1  - Herrmann, Johannes
A1  - Lotz, Christopher
A1  - Karagiannidis, Christian
A1  - Weber-Carstens, Steffen
A1  - Kluge, Stefan
A1  - Putensen, Christian
A1  - Wehrfritz, Andreas
A1  - Schmidt, Karsten
A1  - Ellerkmann, Richard K.
A1  - Oswald, Daniel
A1  - Lotz, Gösta
A1  - Zotzmann, Viviane
A1  - Moerer, Onnen
A1  - Kühn, Christian
A1  - Kochanek, Matthias
A1  - Muellenbach, Ralf
A1  - Gaertner, Matthias
A1  - Fichtner, Falk
A1  - Brettner, Florian
A1  - Findeisen, Michael
A1  - Heim, Markus
A1  - Lahmer, Tobias
A1  - Rosenow, Felix
A1  - Haake, Nils
A1  - Lepper, Philipp M.
A1  - Rosenberger, Peter
A1  - Braune, Stephan
A1  - Kohls, Mirjam
A1  - Heuschmann, Peter
A1  - Meybohm, Patrick
T1  - Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation
JF  - Critical Care
N2  - Background
Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients.
Methods
673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival.
Results
Most patients were between 50 and 70 years of age. PaO\(_{2}\)/FiO\(_{2}\) ratio prior to ECMO was 72 mmHg (IQR: 58–99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41–0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28–1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events.
Conclusions
Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.
KW  - Covid-19
KW  - extracorporeal membrane oxygenation (ECMO)
KW  - intensive care unit
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-299686
VL  - 26
IS  - 1
ER  -