Polyuria in COVID-19 Patients Undergoing Extracorporeal Membrane Oxygenation

Area of Science:

• Critical Care Medicine
• Nephrology
• Infectious Diseases

Background:

• The COVID-19 pandemic led to increased use of veno-venous extracorporeal membrane oxygenation (VV ECMO).
• Clinical observation noted frequent polyuria in COVID-19 patients undergoing VV ECMO.
• This study investigates the incidence, causes, and implications of polyuria in this patient population.

Purpose of the Study:

• To determine the incidence of polyuria in COVID-19 patients on VV ECMO.
• To explore potential factors associated with polyuria during VV ECMO.
• To assess the impact of polyuria on mortality in these patients.

Main Methods:

• A cohort of 68 SARS-CoV-2 positive patients receiving VV ECMO was analyzed.
• Patients were classified into polyuria (PU, urine output ≥3000 mL/day) and non-polyuria (NPU, <3000 mL/day) groups within seven days of ECMO initiation.
• Statistical analysis compared fluid intake, balance, creatinine, plasma osmolality, lactate, urea, and sodium levels between groups.

Main Results:

• Polyuria occurred in 51.5% of patients within seven days of VV ECMO initiation.
• No significant difference in mortality was observed between the PU and NPU groups (60.0% vs. 60.6%).
• Significant differences were noted in fluid intake, 24-hour fluid balance, creatinine, plasma osmolality, lactate, urea, and sodium levels between the groups. Plasma osmolality increased post-ECMO initiation.

Conclusions:

• Polyuria is a common finding in COVID-19 patients treated with VV ECMO.
• Polyuria does not appear to be associated with increased mortality in this cohort.
• Further research is needed to understand the mechanisms and clinical significance of polyuria during VV ECMO for COVID-19 management.