Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

L'internationalisation des banques françaises

Club Finance Internationale, Groupe HEC, Livre Blanc, n°

La traduction financière du risque politique lié aux investissements à l'étranger

Cahier de Recherche du Groupe HEC, N°19

L'avenir de Paris comme place financière internationale

Cahier de Recherche du Groupe HEC Paris, n° 20

Foreign investment risk and the multinational corporation

Cahier de Recherche du Groupe HEC Paris, n° 43

Le mont Royal. Forme naturelle, paysages et territorialités urbaines.

La question du lieu en géographie est redevenue d'actualité depuis quelque temps. Cela tient notamment au fait qu'elle permet d'approfondir la réflexion sur la relation qui existe entre les caractères génériques et les caractères spécifiques de chacun des lieux. Cet article propose une voie d'interprétation de cette relation en analysant, à partir de l'exemple du mont Royal, l'articulation entre la forme géographique et ses significations symboliques et mythiques

Le financement des PME par les banques

Yoncourt Bernard, Marois Thierry. Le financement des PME par les banques. In: Revue d'économie financière, n°12-13, 1990. Articles divers. pp. 27-40

The internationalisation process of banks: an overview of theoretical developments, in the aftermath of the European single market

Cahier de Recherche du Groupe HEC Paris, n° 48