Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Crisis Standards of Care

ASAIO J. 2021 Mar 1;67(3):245-249. doi: 10.1097/MAT.0000000000001376.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has placed extraordinary strain on global healthcare systems. Use of extracorporeal membrane oxygenation (ECMO) for patients with severe respiratory or cardiac failure attributed to COVID-19 has been debated due to uncertain survival benefit and the resources required to safely deliver ECMO support. We retrospectively investigated adult patients supported with ECMO for COVID-19 at our institution during the first 80 days following New York City's declaration of a state of emergency. The primary objective was to evaluate survival outcomes in patients supported with ECMO for COVID-19 and describe the programmatic adaptations made in response to pandemic-related crisis conditions. Twenty-two patients with COVID-19 were placed on ECMO during the study period. Median age was 52 years and 18 (81.8%) were male. Twenty-one patients (95.4%) had severe ARDS and seven (31.8%) had cardiac failure. Fifteen patients (68.1%) were managed with venovenous ECMO while 7 (31.8%) required arterial support. Twelve patients (54.5%) were transported on ECMO from external institutions. Twelve patients were discharged alive from the hospital (54.5%). Extracorporeal membrane oxygenation was used successfully in patients with respiratory and cardiac failure due to COVID-19. The continued use of ECMO, including ECMO transport, during crisis conditions was possible even at the height of the COVID-19 pandemic.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / mortality
  • COVID-19 / therapy*
  • Extracorporeal Membrane Oxygenation / methods*
  • Extracorporeal Membrane Oxygenation / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2
  • Standard of Care
  • Treatment Outcome
  • Young Adult