{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:16:02Z","timestamp":1791404162588,"version":"4.3.3"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":1707,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The role of and needs for extracorporeal membrane oxygenation (ECMO) at a population level during the coronavirus disease (COVID-19) pandemic have not been completely established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify the cumulative incidence of ECMO use in the first pandemic wave and to describe the Nationwide Chilean cohort of ECMO-supported patients with COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population-based study from March 3 to August 31, 2020, using linked data from national agencies. The cumulative incidence of ECMO use and mortality risk of ECMO-supported patients were calculated and age standardized. In addition, a retrospective cohort analysis was performed. Outcomes were 90-day mortality after ECMO initiation, ECMO-associated complications, and hospital length of stay. Cox regression models were used to explore risk factors for mortality in a time-to-event analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Ninety-four patients with COVID-19 were supported with ECMO (0.42 per population of 100,000, 14.89 per 100,000 positive cases, and 1.2% of intubated patients with COVID-19); 85 were included in the cohort analysis, and the median age was 48 (interquartile range [IQR], 41\u201355) years, 83.5% were men, and 42.4% had obesity. The median number of pre-ECMO intubation days was 4 (IQR, 2\u20137), the median PaO2\/Fi \u00a0O2 ratio was 86.8 (IQR, 64\u201399) mm Hg, 91.8% of patients were prone positioned, and 14 patients had refractory respiratory acidosis. Main complications were infections (70.6%), bleeding (38.8%), and thromboembolism (22.4%); 52 patients were discharged home, and 33 died. The hospital length of stay was a median of 50 (IQR, 24\u201369) days. Lower respiratory system compliance and higher driving pressure before ECMO initiation were associated with increased mortality. A duration of pre-ECMO intubation \u226510 days was not associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Documenting nationwide ECMO needs may help in planning ECMO provision for future COVID-19 pandemic waves. The 90-day mortality of the Chilean cohort of ECMO-supported patients with COVID-19 (38.8%) is comparable to that of previous reports.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202011-4166oc","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T17:56:43Z","timestamp":1617731803000},"page":"34-43","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":72,"title":["Extracorporeal Membrane Oxygenation for COVID-19\u2013associated Severe Acute Respiratory Distress Syndrome in Chile: A Nationwide Incidence and Cohort Study"],"prefix":"10.1093","volume":"204","author":[{"given":"Rodrigo A.","family":"Diaz","sequence":"first","affiliation":[{"name":"Unidad de Oxigenaci\u00f3n por Membrana Extracorp\u00f3rea, Cl\u00ednica Las Condes, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5657-7616","authenticated-orcid":false,"given":"Jer\u00f3nimo","family":"Graf","sequence":"additional","affiliation":[{"name":"Departamento de Paciente Cr\u00edtico, Cl\u00ednica Alemana de Santiago, Santiago, Chile"},{"name":"Facultad de Medicina, Cl\u00ednica Alemana\u2013Universidad de Desarrollo, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Zambrano","sequence":"additional","affiliation":[{"name":"Instituto Nacional del T\u00f3rax, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico, Complejo Asistencial Dr. S\u00f3tero del R\u00edo, Santiago, Chile"},{"name":"Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Unidad de Cirug\u00eda Cardiaca, Departamento Cardiovascular"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian I.","family":"Bravo","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo A.","family":"Salazar","sequence":"additional","affiliation":[{"name":"Equipo de Oxigenaci\u00f3n por Membrana Extracorp\u00f3rea, Hospital de Las Higueras de Talcahuano, Talcahuano, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Bahamondes","sequence":"additional","affiliation":[{"name":"Servicio de Cirug\u00eda Cardiovascular and"},{"name":"Departamento de Cirug\u00eda, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis B.","family":"Castillo","sequence":"additional","affiliation":[{"name":"Unidad de Pacientes Cr\u00edticos, Hospital Barros Luco Trudeau, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham I. 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