{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:53:08Z","timestamp":1791366788182,"version":"4.3.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The transferability of pre-ECMO characteristics and established mortality prediction tools across COVID-19 (C-19) and non-COVID-19 (nC-19) acute respiratory distress syndrome (ARDS) remains uncertain. We compared clinical characteristics, organ dysfunction, respiratory support and outcome in a large cohort of patients treated with veno-venous extracorporeal membrane oxygenation (vvECMO), and explored mortality prediction in C-19 ARDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single-center cohort study included\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009600 vvECMO patients (C-19:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009245, nC-19:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009355) hospitalized at the Charit\u00e9 ARDS ECMO Center from 01\/2007 to 12\/2018 (nC-19) and 03\/2020\u201301\/2022 (C-19). Pre-ECMO clinical and laboratory variables were compared between cohorts and by ICU survival. RESP score performance was assessed, and an exploratory C-19 ECMO mortality prediction (CEMP) score was derived from pre-ECMO variables using an explainable machine-learning workflow with SHapley Additive exPlanations (SHAP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      C-19 patients were older (median 57.0 vs. 51.0 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), more often male (74.7% vs. 66.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0337), and had a higher BMI (29.3 vs. 26.0\u00a0kg\/m\u00b2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). nC-19 patients had a higher CCI (3 vs. 2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0137) and SOFA score (12 vs. 11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0004). Septic shock before vvECMO initiation was more prevalent in nC-19 patients (65.4% vs. 13.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and nC-19 patients had higher median baseline bilirubin, creatinine, and lactate levels (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). nC-19 patients had higher median PEEP, pPeak, and plateau pressure than C-19 patients, whereas their PaO\u2082\/FiO\u2082 ratio was lower (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Duration of vvECMO support was longer in C-19 patients (26.0 vs. 12.6 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001); ICU mortality did not differ significantly (55.1% vs. 47.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0966). RESP showed limited discrimination in C-19 patients, and the CEMP derivation analysis yielded an apparent AUC of 0.757 (95% CI 0.69\u20130.82).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This large single-center comparative vvECMO cohort highlights differences between C-19 and nC-19 ARDS in organ dysfunction burden, respiratory characteristics, and treatment duration. ICU mortality did not differ significantly between groups. RESP showed limited discrimination in C-19; CEMP remains exploratory and requires calibration and independent external validation before clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-026-04306-9","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:54:30Z","timestamp":1791363270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-ECMO characteristics, organ dysfunction and exploratory mortality prediction in COVID-19 versus non-COVID-19 ARDS treated with veno-venous ECMO: a retrospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Mirja","family":"Mittermaier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Adriaan","family":"Graw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander H.","family":"Thieme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Lieberwirth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Hunsicker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zickler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan M.","family":"Kruse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Uhrig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Pergantis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Machleidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Jacobi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"B\u00fcnger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela Ludmilla","family":"Merten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha","family":"Landoll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Karagiannidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif-Erik","family":"Sander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Uwe","family":"Eckardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Spies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Witzenrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Weber-Carstens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Menk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"M\u00fcller-Redetzky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"4306_CR1","first-page":"e0671","volume":"4","author":"M Russ","year":"2022","unstructured":"Russ M, et al. 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