Inflammatory and microbiological associations with near-fatal asthma requiring extracorporeal membrane oxygenation

Sunil Patel; Neeraj M. Shah; Akanksha M. Malhotra; Christopher Lockie; Luigi Camporota; Nicholas Barrett; Brian D. Kent; David J. Jackson

doi:10.1183/23120541.00267-2019

Tables

TABLE 1

Clinical, inflammatory and microbiological characteristics on day of admission to hospital and during intensive care unit (ICU) stay

	ECMO (n=22)	MV only (n=54)	p-value
Demographics
Patients n	22	54
Age years	30±14	43±15	0.002
Females	16/22 (72.7%)	19/54 (35.2%)	0.003
Ex- or current smokers	12/22 (54.5%)	30/54 (55.6%)	0.937
Atopic	12/22 (55%)	20/54 (37%)	0.161
Treatment on admission
No treatment	3/22 (17.6%)	2/54 (3.9%)	NA
Short-acting β-agonist only	2/22 (11.8%)	8/54 (15.7%)	NA
Low-dose ICS	2/22 (11.8%)	15/54 (29.4%)	NA
Low-dose ICS/LABA	6/22 (35.3%)	6/54 (11.8%)	NA
Medium-dose ICS/LABA	3/22 (17.6%)	14/54 (27.5%)	NA
High-dose ICS/LABA	1/22 (5.9%)	6/54 (11.8%)	NA
Maintenance prednisolone or biologic therapies	0/22 (0.0%)	0/54 (0.0%)	NA
Laboratory results
Total white cell count 10⁹ L⁻¹	15.5±6.5	12.1±4.4	0.013
Blood eosinophil count 10⁹ L⁻¹	0.5±1.0	0.5±1.0	0.822
Blood neutrophil count 10⁹ L⁻¹	10.6±3.6	8.2±4.0	0.083
C-reactive protein mg·L⁻¹	48.4±70.9	49.1±92.3	0.976
Serum total immunoglobulin E kU·L⁻¹	1178±1714 (n=13)	1089±1988 (n=16)	0.899
Duration of mechanical ventilation days	12.6±12.6	5.2±8.4	0.005
Duration of ECMO days	6.0±1.9	NA	NA
ICU length of stay days	15.0±10.7 (n=20)	5.4±7.1 (n=54)	<0.001
Hospital length of stay days	22.1±17.2 (n=22)	12.8±16.6 (n=54)	0.033
Pre-ECMO/MV
pH	7.12±0.2 (n=19)	7.27±0.1 (n=53)	<0.001
P_O₂ kPa	14±6.0 (n=17)	15.9±8.5 (n=53)	0.414
P_CO₂ kPa	12.8±4.1 (n=18)	7.26±2.1 (n=53)	<0.001
Lactate mmol·L⁻¹	1.1±0.5 (n=15)	2.7±1.7 (n=53)	0.001
Positive respiratory virus isolate	12/22 (54.5%)	8/29 (27.6%)	0.052
Influenza A	3/22 (13.6%)	4/29 (13.8%)	0.987
Adenovirus^#	2/22 (9.1%)	0/29 (0.0%)	0.098
Rhinovirus^#	6/22 (27.3%)	2/29 (6.9%)	0.048
Coronavirus	1/22 (4.5%)	1/29 (3.4%)	0.842
RSV	0/22 (0.0%)	1/29 (3.4%)	0.379
Parainfluenza	1/22 (4.5%)	0/29 (0.0%)	0.246
Positive bacterial isolate	7/22 (31.8%)	11/29 (37.9%)	0.660
Staphylococcus aureus	3/22 (13.6%)	2/29 (6.9%)	0.641
Streptococcus pneumoniae	0/22 (0.0%)	3/29 (10.3%)	0.249
Haemophilus influenzae	0/22 (0.0%)	3/29 (10.3%)	0.249
Pseudomonas aeruginosa	0/22 (0.0%)	2/29 (6.9%)	0.499
Other^¶	4/22 (18.1%)	1/29 (3.4%)	0.152
Positive fungal isolates	8/22 (36.4%)	3/29 (10.3%)	0.025
Candida albicans	7/22 (31.8%)	3/29 (10.3%)	0.079
Aspergillus fumigatus^#	2/22 (9.1%)	0/29 (0.0%)	0.181

Data are presented as mean±sd or n/N (%) unless otherwise stated. ECMO: extracorporeal membrane oxygenation; MV: mechanical ventilation; ICS: inhaled corticosteroid; LABA: long-acting β-agonist; P_O₂: oxygen tension; P_CO₂: carbon dioxide tension; RSV: respiratory syncytial virus; NA: not applicable. ^#: includes samples with more than one isolate; ^¶: Enterobacteriaceae, Stenotrophomonas maltophilia or Veillonella species.