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<p>Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a resource intensive and expensive therapy increasingly used to treat a select group of patients with severe acute respiratory distress syndrome (ARDS). High levels of Interleukin-10 (IL-10) are reported to be predictive of mortality in non-COVID ARDS patients receiving ECMO. In this study we evaluated if levels of biomarkers including IL-10 can predict mortality if measured prior to ECMO initiation in patients with COVID-19 ARDS. A total of sixteen patients with COVID-related ARDS undergoing treatment with ECMO were included in the pre-ECMO biomarker analysis, while samples from a total of 22 patients with post-ECMO samples were analyzed. Nine of sixteen patients with pre-ECMO samples (56%) survived to hospital discharge. There was no difference in baseline demographics between survivors and non-survivors. In univariate analysis, survivors had no difference in IL-10 levels prior to ECMO initiation although we identified several other biomarkers (Ang 1 and TNF-alpha with logistical regression, Mitochondrial DNA and IP-10 with Kaplan–Meier analysis) that differed significantly between survivors and non-survivors. Moreover, as opposed to a prior study, area under the curve (AUC) analysis showed that IL-10 levels were not predictive of survival. We advise caution for utilizing a single biomarker as outcome predictor in this highly complex population with often long clinical courses despite our promising results.</p>

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Biomarker studies to predict outcomes of patients with COVID-19 related acute respiratory distress syndrome measured pre and post initiation of veno venous extracorporeal membrane oxygenation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月3日

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  • Mazen F. Odish,
  • Hunter Gage,
  • Michael T. Y. Lam,
  • Mark Hepokoski,
  • Travis Pollema,
  • Khang Tong,
  • Lin Liu,
  • Atul Malhotra,
  • Robert L. Owens,
  • Angela Meier

摘要

Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a resource intensive and expensive therapy increasingly used to treat a select group of patients with severe acute respiratory distress syndrome (ARDS). High levels of Interleukin-10 (IL-10) are reported to be predictive of mortality in non-COVID ARDS patients receiving ECMO. In this study we evaluated if levels of biomarkers including IL-10 can predict mortality if measured prior to ECMO initiation in patients with COVID-19 ARDS. A total of sixteen patients with COVID-related ARDS undergoing treatment with ECMO were included in the pre-ECMO biomarker analysis, while samples from a total of 22 patients with post-ECMO samples were analyzed. Nine of sixteen patients with pre-ECMO samples (56%) survived to hospital discharge. There was no difference in baseline demographics between survivors and non-survivors. In univariate analysis, survivors had no difference in IL-10 levels prior to ECMO initiation although we identified several other biomarkers (Ang 1 and TNF-alpha with logistical regression, Mitochondrial DNA and IP-10 with Kaplan–Meier analysis) that differed significantly between survivors and non-survivors. Moreover, as opposed to a prior study, area under the curve (AUC) analysis showed that IL-10 levels were not predictive of survival. We advise caution for utilizing a single biomarker as outcome predictor in this highly complex population with often long clinical courses despite our promising results.