{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:33:38Z","timestamp":1777916018461,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000865","name":"The Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-034765"],"award-info":[{"award-number":["INV-034765"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Queensland Health"},{"DOI":"10.13039\/501100018853","name":"The Prince Charles Hospital Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018853","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Wesley Medical Research; Fisher & Paykel Healthcare"},{"DOI":"10.13039\/501100001794","name":"The University of Queensland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001794","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Health Research Board of Ireland"},{"name":"Estonian Research Council grant","award":["PRG 2078"],"award-info":[{"award-number":["PRG 2078"]}]},{"name":"Advance Queensland fellowship program"},{"name":"European Union\u2019s Horizon 2020 research and innovation program","award":["754550"],"award-info":[{"award-number":["754550"]}]},{"name":"\u201cLa Caixa\u201d Foundation","award":["100010434"],"award-info":[{"award-number":["100010434"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liberation from sedation may be beneficial for patients with acute respiratory distress syndrome supported by veno-venous (VV) extracorporeal membrane oxygenation (ECMO). Currently, there is limited evidence to support this approach. Therefore, this study aimed to compare the 90-day patient mortality of different sedation strategies in COVID-19 patients supported with VV ECMO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective, observational sub-study of the COVID-19 Critical Care Consortium database including COVID-19 patients supported with VV ECMO. Two cohorts were compared: high sedation patients who received neuromuscular blocking agents (NMBAs) throughout ECMO and low sedation patients who did not receive NMBA consistently. Patients\u2019 level of sedation during ECMO was also considered. The primary outcome was 90-day in-hospital mortality and was assessed using cause-specific Cox proportional hazard models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>224 low and 104 high sedation patients were included. Pre-ECMO respiratory condition prior was similar between groups, except for the ratio of partial pressure of oxygen to inspired fraction of oxygen, which was lower in the high sedation group at 93 [61\u2013130] than the low sedation group at 106 [69\u2013140]. No difference was observed in disease severity scores between cohorts. Low sedation patients had longer ECMO runs, more circuit changes, but lower infectious and hemorrhagic complications. Higher sedation was associated with a hazard ratio for death of 3.23 (95% CI 2.16\u20134.83) compared to low sedation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced sedation in COVID-19 ECMO patients is feasible and may be associated with improved survival and reduced complications compared to continuous paralysis, albeit with longer ECMO runs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251324136","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T14:17:17Z","timestamp":1740579437000},"page":"1689-1700","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Level of sedation in patients with COVID-19 supported with ECMO: A comparative analysis of the critical care consortium international database"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-4816","authenticated-orcid":false,"given":"Silver","family":"Heinsar","sequence":"first","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia"},{"name":"Department of Cardiology, North Estonia Medical Centre, Tallinn, Estonia"},{"name":"Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1863-0484","authenticated-orcid":false,"given":"Ahmed","family":"Labib","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hamad Medical Corporation, Doha, Qatar"},{"name":"Department of Anesthesiology, Weill Cornell Medical College, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela","family":"Cespedes","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia"},{"name":"Australian eHealth Research Centre, The Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1738-4448","authenticated-orcid":false,"given":"Jordi","family":"Riera","sequence":"additional","affiliation":[{"name":"Vall d\u2019Hebron University Hospital, Critical Care Department, Barcelona, Spain"},{"name":"Vall d\u2019Hebron Research Institute, SODIR, Barcelona, Spain"},{"name":"Instituto de Salud Carlos III, CIBERES, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"White","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3147-5044","authenticated-orcid":false,"given":"Akram","family":"Zaaqoq","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care, University of Virginia, Charlottesville, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey P","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Congenital Heart Center, University of Florida, Gainesville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4531-6151","authenticated-orcid":false,"given":"Hergen","family":"Buscher","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, St Vincent\u2019s Hospital, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peta M. A.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Boston, MA, USA"},{"name":"Department of Pediatrics, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Ciullo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, University of Utah Health, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, University of Colorado, Denver, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacky Y","family":"Suen","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluigi Li","family":"Bassi","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-2045","authenticated-orcid":false,"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F","family":"Fraser","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1313-6498","authenticated-orcid":false,"given":"Giles","family":"Peek","sequence":"additional","affiliation":[{"name":"Congenital Heart Center, University of Florida, Gainesville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"On behalf of the COVID-19 Critical Care Consortium (COVID Critical)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"ECMO registry of the extracorporeal Life support organization (ELSO)","year":"2022","unstructured":"ECMO registry of the extracorporeal Life support organization (ELSO). 2022. 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