Mortalidad con ECMO en pacientes críticos infectados por SARS-CoV-2 durante la pandemia de COVID-19.Una revisión sistemática

  1. Néstor Báez Ferrer 1
  2. Alejandra Bompart Cairós 2
  3. Dénis López Rial 2
  4. Pedro Abreu González 3
  5. Daniel Hernández-Vaquero Panizo 4
  6. Alberto Domínguez Rodríguez 1
  1. 1 Servicio de Cardiología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
  2. 2 Facultad de Ciencias de la Salud, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife, España
  3. 3 Departamento de Ciencias Médicas Básicas, Unidad de Fisiología, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, España
  4. 4 Servicio de Cirugía Cardiaca, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
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Revista:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Año de publicación: 2021

Volumen: 3

Número: 3

Páginas: 196-203

Tipo: Artículo

DOI: 10.24875/RECIC.M21000204 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: REC: Interventional Cardiology

Objetivos de desarrollo sostenible

Resumen

Introducción y objetivos: El coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2) genera una enfermedad infecciosa que puede presentarse como síndrome de distrés respiratorio del adulto (SDRA). Sin un tratamiento farmacológico eficaz, el oxigenador extracorpóreo de membrana (ECMO) es fundamental cuando en los casos graves fracasa la ventilación mecánica invasiva. Presentamos una revisión sistemática de los trabajos publicados en el año 2020 para analizar la mortalidad de pacientes con SDRA por SARS-CoV-2 que precisaban ECMO. Métodos: Se realizó una revisión sistemática en Medline combinando palabras clave sobre SARS-CoV-2 y ECMO. Se incluyeron todos los estudios publicados durante el año 2020 que registraran casos positivos de SARS-CoV-2 tratados con ECMO, ya fueran estudios observacionales o series de casos. Sin embargo, debido a la heterogeneidad en la metodología de los trabajos, no se pudo llevar a cabo un análisis estadístico adecuado, lo cual limita los hallazgos. Resultados: La búsqueda identificó 41 publicaciones y se recogieron 2.007 casos de pacientes con infección grave por SARS-CoV-2 que precisaron soporte invasivo con ECMO. De estos, 985 (49%) mejoraron clínicamente y fueron descanulados o dados de alta del hospital, y 660 (32,8%) fallecieron a pesar del soporte invasivo. Solo 357 (17,7%) pacientes aún persistían con necesidad de asistencia ventilatoria con ECMO en el momento de la publicación de los estudios, sin que se describa la evolución clínica final. Conclusiones: El tratamiento con ECMO podría ser útil en pacientes con SDRA por SARS-CoV-2, según las directrices de las guías clínicas y en función de la disponibilidad de los recursos económicos durante la pandemia. La realización de un ensayo clínico aleatorizado que compare el uso de ECMO con el tratamiento convencional ventilatorio invasivo arrojaría mayor evidencia, con el fin de aportar más datos sobre el tratamiento de la infección grave por SARS-CoV-2.

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Fuente de los datos: Dialnet