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1. Six-Month Pulmonary Function After Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Patients

Author

Amédée Ego, MD, Olivier Taton, MD, Alexandre Brasseur, MD, Yves Laurent, MD, Fabio Silvio Taccone, MD, PhD, and Romain Courcelle, MD

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

OBJECTIVES:. Venovenous extracorporeal membrane oxygenation has been largely used in patients with refractory acute respiratory distress syndrome due to coronavirus disease 2019. Few data on long-term pulmonary function among venovenous extracorporeal membrane oxygenation survivors are available. DESIGN:. Retrospective, observational cohort. SETTING:. Two mixed medical-surgical tertiary (30 beds) and secondary (22 beds) ICUs. PATIENTS:. All critically ill adult coronavirus disease 2019 survivors treated with venovenous extracorporeal membrane oxygenation between March 10, and April 30, 2020. MEASUREMENTS AND MAIN RESULTS:. The last available lung function and 6-minute walking tests, performed after a median of 178 days (ranges, 72–232 d) from ICU admission, were analyzed. Among the 32 coronavirus disease 2019 patients treated by venovenous extracorporeal membrane oxygenation during the study period, 11 (34%; median age 56 yr; median duration of mechanical ventilation and extracorporeal membrane oxygenation therapy of 26 and 15 d, respectively) were successfully weaned and discharged home. Spirometry was performed in nine patients; the volumetric lung function was preserved, that is, median forced vital capacity was 83% of predicted value (51–99% of predicted value), and median forced expiratory volume in 1 second was 82% of predicted value (60–99% of predicted value). Also, the median residual volume and the lung capacity were 100% of predicted value (50–140% of predicted value) and 90% of predicted value (50–100% of predicted value); only the diffusion capacity of the lung for carbon monoxide and 6-minute walking test were decreased (58% of predicted value [37–95% of predicted value] and 468 meters (365–625 meters), corresponding to [63–90% of predicted value], respectively). CONCLUSIONS:. Among survivors from severe coronavirus disease 2019 pneumonia treated with venovenous extracorporeal membrane oxygenation, preserved long-term volumetric lung function with decreased diffusion capacity of lung carbon monoxide was observed.

Published
2021
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2. Six-Month Pulmonary Function After Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Patients

Author

Romain Courcelle, Fabio Silvio Taccone, Alexandre Brasseur, Yves Laurent, Olivier Taton, and Amédée Ego

Subjects
Mechanical ventilation, Spirometry, Vital capacity, Lung, medicine.diagnostic_test, business.industry, RC86-88.9, medicine.medical_treatment, Brief Report, Medical emergencies. Critical care. Intensive care. First aid, General Medicine, acute respiratory distress syndrome, extracorporeal membrane oxygenation, Pulmonary function testing, coronavirus disease 2019, medicine.anatomical_structure, pulmonary function test, Refractory, Anesthesia, medicine, Extracorporeal membrane oxygenation, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Lung volumes, business
Abstract

Supplemental Digital Content is available in the text., OBJECTIVES: Venovenous extracorporeal membrane oxygenation has been largely used in patients with refractory acute respiratory distress syndrome due to coronavirus disease 2019. Few data on long-term pulmonary function among venovenous extracorporeal membrane oxygenation survivors are available. DESIGN: Retrospective, observational cohort. SETTING: Two mixed medical-surgical tertiary (30 beds) and secondary (22 beds) ICUs. PATIENTS: All critically ill adult coronavirus disease 2019 survivors treated with venovenous extracorporeal membrane oxygenation between March 10, and April 30, 2020. MEASUREMENTS AND MAIN RESULTS: The last available lung function and 6-minute walking tests, performed after a median of 178 days (ranges, 72–232 d) from ICU admission, were analyzed. Among the 32 coronavirus disease 2019 patients treated by venovenous extracorporeal membrane oxygenation during the study period, 11 (34%; median age 56 yr; median duration of mechanical ventilation and extracorporeal membrane oxygenation therapy of 26 and 15 d, respectively) were successfully weaned and discharged home. Spirometry was performed in nine patients; the volumetric lung function was preserved, that is, median forced vital capacity was 83% of predicted value (51–99% of predicted value), and median forced expiratory volume in 1 second was 82% of predicted value (60–99% of predicted value). Also, the median residual volume and the lung capacity were 100% of predicted value (50–140% of predicted value) and 90% of predicted value (50–100% of predicted value); only the diffusion capacity of the lung for carbon monoxide and 6-minute walking test were decreased (58% of predicted value [37–95% of predicted value] and 468 meters (365–625 meters), corresponding to [63–90% of predicted value], respectively). CONCLUSIONS: Among survivors from severe coronavirus disease 2019 pneumonia treated with venovenous extracorporeal membrane oxygenation, preserved long-term volumetric lung function with decreased diffusion capacity of lung carbon monoxide was observed.

Published
2021

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