Polyuria in COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Statistical Analysis
2.3. Technical Characteristics
3. Results
3.1. Patients’ Characteristics
3.2. Statistical Results
3.3. Technical Results
4. Discussion
5. Future Directions and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
List of Abbreviations
ARDS | acute respiratory distress syndrome |
ADH | antidiuretic hormone |
COVID-19 | coronavirus disease 2019 |
ELSO | Extracorporeal Life Support Organization |
ICU | intensive care unit |
NPU | non-polyuric |
PCR | polymerase chain reaction |
PU | polyuric |
SARS-CoV-2 | severe acute respiratory syndrome coronavirus 2 |
VA ECMO | veno-atrial extracorporeal membrane oxygenation |
VV ECMO | veno-venous extracorporeal membrane oxygenation |
Appendix A
Group | Parameters | Day −2 | Day 0 | Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | p-Value # | p-Value * |
---|---|---|---|---|---|---|---|---|---|---|---|---|
PU | Diuresis [mL/24 h] | 2225 ± 1443 | 2605 ± 1640 | 3303 ± 1789 | 3793 ± 1451 | 4347 ± 1722 | 4689 ± 1693 | 4529 ± 1220 | 4566 ± 1993 | 4411 ± 2377 | <0.01 | - |
NPU | Diuresis [mL/24 h] | 1504 ± 872 | 1358 ± 814 | 1864 ± 631 | 1977 ± 684 | 2148 ± 799 | 2514 ± 725 | 2777 ± 748 | 2698 ± 683 | 2947 ± 886 | ||
PU | ECMO flow rate [L/min] | - | 4.6 ± 0.8 | 4.9 ± 0.9 | 4.9 ± 1.0 | 5.0 ± 1.1 | 4.9 ± 1.1 | 4.9 ± 1.1 | 5.0 ± 1.3 | 4.9 ± 1.4 | - | 0.82 |
NPU | ECMO flow rate [L/min] | - | 4.4 ± 0.8 | 4.8 ± 0.9 | 4.9 ± 1.0 | 5.1 ± 1.2 | 5.0 ± 1.1 | 5.1 ± 1.0 | 5.1 ± 1.1 | 5.0 ± 1.0 | ||
PU | Creatinine [mg/dL] | 0.72 ± 0.3 | 0.78 ± 0.34 | 0.76 ± 0.45 | 0.7 ± 0.42 | 0.68 ± 0.4 | 0.68 ± 0.34 | 0.7 ± 0.32 | 0.68 ± 0.33 | 0.67 ± 0.35 | - | <0.01 |
NPU | Creatinine [mg/dL] | 0.79 ± 0.26 | 0.88 ± 0.34 | 0.9 ± 0.53 | 0.92 ± 0.77 | 0.93 ± 0.78 | 0.88 ± 0.7 | 0.84 ± 0.67 | 0.82 ± 0.67 | 0.83 ± 0.67 | ||
PU | Plasma osmolality [mosmol/kgH2O] | 300 ± 18 | 304 ± 16 | 309 ± 15 | 309 ± 14 | 307 ± 14 | 307 ± 16 | 305 ± 19 | 303 ± 18 | 302 ± 19 | <0.01 | <0.01 |
NPU | Plasma osmolality [mosmol/kgH2O] | 300 ± 15 | 308 ± 12 | 310 ± 10 | 316 ± 10 | 317 ± 11 | 317 ± 13 | 318 ± 15 | 316 ± 16 | 315 ± 17 |
Group | Parameters | Day −2 | Day 0 | Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | p-Value # | p-Value * |
---|---|---|---|---|---|---|---|---|---|---|---|---|
PU | Urea [mg/dL] | 44 ± 28 | 45 ± 21 | 50 ± 30 | 48 ± 33 | 46 ± 34 | 44 ± 34 | 44 ± 32 | 42 ± 30 | 42 ± 29 | 0.62 | <0.01 |
NPU | Urea [mg/dL] | 48 ± 27 | 53 ± 25 | 57 ± 24 | 58 ± 26 | 60 ± 30 | 61 ± 32 | 60 ± 34 | 60 ± 36 | 61 ± 38 | ||
PU | Sodium [mmol/L] | 143 ± 8 | 145 ± 7 | 146 ± 6 | 147 ± 5 | 146 ± 5 | 146 ± 6 | 145 ± 7 | 144 ± 7 | 144 ± 8 | <0.01 | <0.01 |
NPU | Sodium [mmol/L] | 142 ± 6 | 148 ± 5 | 146 ± 5 | 148 ± 4 | 149 ± 4 | 149 ± 5 | 149 ± 5 | 149 ± 6 | 148 ± 6 | ||
PU | Lactate [mg/dL] | 13 ± 3 | 14 ± 8 | 13 ± 5 | 11 ± 4 | 10 ± 4 | 9 ± 3 | 8 ± 2 | 9 ± 3 | 8 ± 3 | - | <0.01 |
NPU | Lactate [mg/dL] | 15 ± 4 | 17 ± 7 | 14 ± 5 | 12 ± 3 | 12 ± 4 | 10 ± 4 | 10 ± 3 | 9 ± 3 | 9 ± 3 | ||
PU | Procalcitonin [ng/mL] | 0.56 ± 0.7 | 0.86 ± 1.23 | 1.0 ± 1.3 | 0.79 ± 1.02 | 0.86 ± 1.3 | 0.79 ± 1.1 | 0.6 ± 0.75 | 0.47 ± 0.49 | 0.45 ± 0.42 | - | 0.41 |
NPU | Procalcitonin [ng/mL] | 0.58 ± 0.79 | 0.92 ± 0.92 | 1.46 ± 2.06 | 1.08 ± 1.52 | 2.28 ± 8.66 | 0.59 ± 0.61 | 0.49 ± 0.51 | 0.5 ± 0.77 | 0.44 ± 0.59 | ||
PU | Fluid intake [mL/24 h] | 3296 ± 1551 | 3816 ± 2445 | 4402 ± 1846 | 4429 ± 1495 | 4684 ± 2086 | 5002 ± 1718 | 4938 ± 1748 | 5064 ± 2208 | 5375 ± 2346 | - | <0.01 |
NPU | Fluid intake [mL/24 h] | 2385 ± 1275 | 2964 ± 1605 | 3407 ± 1049 | 2985 ± 929 | 3355 ± 922 | 3065 ± 786 | 3036 ± 800 | 3291 ± 1034 | 3443 ± 1183 | - | - |
PU | Fluid balance [mL/24 h] | 604 ± 920 | 821 ± 1333 | 331 ± 1447 | 23 ± 1126 | −565 ± 1528 | −276 ± 1178 | −201 ± 1334 | −128 ± 1438 | 153 ± 1343 | - | 0.01 |
NPU | Fluid balance [mL/24 h] | 307 ± 1032 | 1161 ± 1175 | 863 ± 1117 | 261 ± 1088 | 327 ± 979 | 90 ± 1175 | −195 ± 1019 | 75 ± 1112 | −202 ± 1368 | - | - |
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Characteristics | Females n (%) | Males n (%) | Age [years] | Weight [kg] |
---|---|---|---|---|
Total patients | 14 (21) | 54 (79) | 52 ± 12 | 95 ± 18 |
PU | 5 (14) | 30 (86) | 49 ± 13 | 94 ± 19 |
NPU | 9 (27) | 24 (73) | 54 ± 10 | 95 ± 15 |
Cannulation Site | Femoral Right and Left (Vf − Vf) | Femoral Right and Internal Jugular Right (Vf − Vj) | Internal Jugular Right and Femoral Left (Vf − Vj) |
---|---|---|---|
All patients n (%) | 50 (73.5) | 16 (23.5) | 2 (3) |
PU | 28 (80) | 7 (20) | 0 |
NPU | 22 (66.7) | 9 (27.3) | 2 (6) |
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Rausch, J.; Steinbicker, A.U.; Friedrichson, B.; Flinspach, A.N.; Zacharowski, K.; Adam, E.H.; Piekarski, F. Polyuria in COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation. J. Clin. Med. 2024, 13, 4081. https://doi.org/10.3390/jcm13144081
Rausch J, Steinbicker AU, Friedrichson B, Flinspach AN, Zacharowski K, Adam EH, Piekarski F. Polyuria in COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation. Journal of Clinical Medicine. 2024; 13(14):4081. https://doi.org/10.3390/jcm13144081
Chicago/Turabian StyleRausch, Johannes, Andrea U. Steinbicker, Benjamin Friedrichson, Armin N. Flinspach, Kai Zacharowski, Elisabeth H. Adam, and Florian Piekarski. 2024. "Polyuria in COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation" Journal of Clinical Medicine 13, no. 14: 4081. https://doi.org/10.3390/jcm13144081