Multi-institutional Analysis of 100 Consecutive Patients with COVID-19 and Severe Pulmonary Compromise Treated with Extracorporeal Membrane Oxygenation: Outcomes and Trends Over Time
Abstract: The purpose of this study was to assess the support of Extracorporeal Membrane Oxygenation in 100 consecutive COVID-19 patients with severe pulmonary compromise across 20 hospitals. The research evaluates the outcomes and trends in managing COVID-19 within the first 100 consecutive patients with complete data. Of the 50 patients, 49 were supported with veno-venous ECMO and 1 was supported with veno-arterial ECMO.
A multi-institutional database was created by a component of the SpecialtyCare Operative Procedural Registry to capture data including patient characteristics, pre-COVID-19 risk factors, comorbidities, features of ECMO support, medications used to treat COVID-19, and short-term outcomes. ECMO placement criteria was determined by each hospital’s data, and every patient placed on ECMO had severe respiratory failure that was deemed unmanageable.
In the 100 confirmed COVID-19 patients supported with ECMO, 50 patients survived and 50 patients died. Veno-venous ECMO showed a 51% survival rate (49 of 96 patients) while veno-arterial ECMO showed a 25% survival rate (1 of 4 patients). Causes of death included respiratory failure, multisystem organ failure, sepsis, disseminated intravascular coagulation, cerebral bleeding, cardiac arrest, and pneumothorax. The age of survivors was generally younger, averaging 47 years. Since the study concluded, 49 patients have been discharged while 1 remains hospitalized.
This study concludes that ECMO increases the chance of survival in COVID-19 patients with severe pulmonary compromise. Further data and research will determine the best use of ECMO and define how it’s used to manage severely compromised COVID-19 patients. The end goal is to continue to utilize ECMO to increase survival rates.
We highlight the efforts of the following from SpecialtyCare and celebrate their contributions to this research study: Jeffrey P. Jacobs, MD, FACS, FACC, FCCP; Alfred H. Stammers, MSA, PBMS, CCP Emeritus; Linda B. Mongero, CCP Emeritus; Eric A. Tesdahl, Ph.D.; Kirti Patel, MPS, MPH, CCP, LP, CPBMT; Tom Coley, RN, CCP Emeritus; and Anthony K. Sestokas, Ph.D., DABNM.