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Table 1 Pre-ECMO characteristics according to ICU admission before or after July 1, 2020

From: Evolving outcomes of extracorporeal membrane oxygenation support for severe COVID-19 ARDS in Sorbonne hospitals, Paris

Characteristic All (N = 159) ICU admission p
Before July 1 (N = 88) After July 1 (N = 71)
Age, years 51 (43–58) 49 (41–56) 54 (49–60) 0.002
Male 114 (72) 64 (73) 50 (70) 0.784
Body mass index, kg/cm2 30.8 (27.7–35.1) 30.3 (27.7–34.0) 31.0 (27.2–37.0) 0.513
SAPS II 55 (39–64) 46 (30–57) 61 (53–68)  < 0.001
RESP score 4 (2–5) 4 (2–5) 3 (2–4) 0.020
Total SOFA score 11 (9–13) 11 (9–13) 11 (8–13) 0.599
Renal component ≥ 3 24 (15) 15 (17) 9 (13) 0.795
 Cardiovascular component ≥ 3 79 (50) 44 (50) 35 (49) 0.752
 Hematological component ≥ 3 4 (3) 2 (2) 2 (3) 0.556
Comorbidities     
 Hypertension 64 (40) 34 (39) 30 (42) 0.644
 Diabetes 54 (34) 38 (43) 26 (37) 0.525
 Chronic respiratory diseasea 24 (15) 10 (11) 14 (20) 0.143
 Immunocompromisedb 9 (6) 3 (3) 6 (8) 0.189
Time from     
 First symptoms to ICU admission, days 7 (5–10) 7 (5–10) 8 (5–11) 0.452
 First symptoms to intubation, days 10 (7–13) 8 (6–11) 11 (8–17)  < 0.001
 ICU admission to intubation, days 1 (0–3) 0 (0–1) 3 (1–8)  < 0.001
 ICU admission to ECMO, days 7 (3–9) 6 (3–7) 9 (4–12)  < 0.001
 Intubation to ECMO, days 4 (1–7) 4 (3–6) 3 (1–7) 0.115
MERT retrieval on-ECMO from another hospital 135 (85) 66 (75) 69 (97)  < 0.001
High-flow oxygen before intubation 75 (47) 17 (19) 58 (82)  < 0.001
 Duration, days 4 (1–7) 2 (0–4) 5 (1–8) 0.009
Non-invasive ventilation before intubation 32 (20) 6 (7) 26 (37)  < 0.001
 Duration, days 3 (1–6) 2 (3–4) 3 (1–8) 0.575
Volume-assist control ventilation 156 (98) 88 (100) 68 (96) 0.094
Ventilation parameters     
 FiO2 100 (100–100) 100 (100–100) 100 (100–100) 0.359
 PEEP, cmH2O 12 (10–14) 13 (12–14) 12 (10–14) 0.019
 Tidal volume, mL/kg PBW 6.0 (5.6–6.4) 6.0 (5.7–6.4) 6.1 (5.5–6.3) 0.661
 Respiratory rate, breaths/min 30 (26–30) 30 (28–30) 30 (26–30) 0.519
 Plateau pressure, cmH2O 31 (29–32) 31 (29–33) 30 (30–32) 0.717
 Driving pressure, cmH2O c 19 (16–21) 18 (16–20) 19 (16–22) 0.289
 Static compliance, mL/cmH2O 21.5 (17.5–26.4) 22.1 (18.1–26.5) 20.8 (17.0–23.9) 0.148
 Mechanical power, J/min d 23.8 (20.2–27.1) 24.9 (21.9–27.2) 21.4 (19.2–26.4) 0.055
 Ventilatory ratio 2.7 (2.2–3.1) 2.8 (2.3–3.3) 2.5 (2.0–2.9) 0.046
Last blood-gas values pre-ECMO     
 pH 7.32 (7.25–7.39) 7.32 (7.24–7.38) 7.33 (7.26–7.41) 0.143
 PaO2/FiO2 60 (54–69) 60 (54–68) 60 (54–74) 0.601
 PaCO2, mmHg 56 (49–65) 57 (50–67) 53 (48–63) 0.156
 PaO2, mmHg 63 (54–70) 64 (54–71) 63 (55–70) 0.857
 Plasma bicarbonate, mmol/L 27 (23–32) 27 (24–32) 27 (23–33) 0.705
 Arterial lactate, mmol/L 1.6 (1.3–2.1) 1.6 (1.4–2.0) 1.6 (1.3–2.4) 0.858
Laboratory values     
 White-cell count, G/L 13.0 (9.5–18.0) 13.1 (10.0–17.1) 12.9 (8.6–18.9) 0.872
 Lymphocytes, G/L 0.85 (0.50–1.33) 0.96 (0.55–1.46) 0.80 (0.50–1.14) 0.328
Dexamethasone (6 mg/day) started pre-ECMO 74 (47) 16 (18) 58 (82)  < 0.001
Rescue therapy pre-ECMO     
 Any 157 (99) 86 (98) 71 (100) 0.503
 Neuromuscular blockade 150 (94) 83 (94) 67 (94) 1.000
 Prone positioning 146 (92) 82 (93) 64 (90) 0.487
 Inhaled nitric oxide or prostacyclin 68 (43) 31 (35) 37 (52) 0.032
 High-dose corticosteroids 10 (6) 6 (7) 4 (6) 1.000
 Almitrine 1 (0.6) 1 (1) 0 (0) 1.000
Renal replacement therapy 5 (3) 4 (5) 1 (1) 0.381
Cardiac arrest 5 (3) 3 (3) 2 (3) 1.000
  1. Values are expressed as median (interquartile range) or number (%)
  2. ECMO extracorporeal membrane oxygenation, ICU intensive care unit, MERT Mobile ECMO Retrieval Team, PaO2/FiO2 ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen, PEEP positive end-expiratory pressure, PBW predicted body weight, PaCO2 partial pressure of arterial carbon dioxide, RESP Respiratory Extracorporeal Membrane Oxygenation Survival Prediction, SaO2 arterial oxygen saturation, SAPS Simplified Acute Physiology Score, SOFA Sequential Organ-Function Assessment
  3. aDefined as chronic obstructive pulmonary disease or asthma
  4. bDefined as hematological malignancies, active solid tumor or having received specific anti-tumor treatment within 1 year, solid-organ transplant or human immunodeficiency virus-infected, long-term corticosteroids or immunosuppressants
  5. cDefined as plateau pressure minus PEEP
  6. dMechanical power (J/min) = 0·098 × tidal volume × respiratory rate × peak pressure – 1/2 × driving pressure. If not specified, peak pressure was considered equal to plateau pressure