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

Link to article at PubMed

Crit Care Explor. 2021 Jul 16;3(7):e0494. doi: 10.1097/CCE.0000000000000494. eCollection 2021 Jul.


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.

PMID:34291224 | PMC:PMC8288889 | DOI:10.1097/CCE.0000000000000494

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