COVID-19 Pulmonary Failure and Extracorporeal Membrane Oxygenation: First Experience from Three European Extracorporeal Membrane Oxygenation Centers

Abstract

On April 17, 2020, a coronavirus disease 2019 (COVID-19) webinar was held by selected international experts in the field of intensive care and specialized respiratory ECMO centers from Germany, Italy, Spain, and the United Kingdom, which was hosted by the German Heart Centre Berlin/Charité. The experts shared their experience about the treatment of 42 patients with severe acute respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV-ECMO). Patients were predominantly male (male-to-female ratio: 3:1), with a mean age of 51 years (range: 25–73 years). VV-ECMO support was indicated in 30% of the ventilated COVID-19 patients. The mean time requiring mechanical ventilation was 16.5 days, with a mean duration of ECMO support of 10.6 days. At the time of the webinar, a total of 17 patients had already been decannulated from ECMO, whereas six died with multiorgan failure. 18 patients remained on ECMO, with their final outcomes unknown at the time of the webinar. Hospital mortality was 25.6% (as of April 17, 2020). In this respect, VV-ECMO, provided by expert centers, is a recognized and validated mode of advanced life-support during the recent COVID-19 pandemic with good outcomes.

Venovenous extracorporeal membrane oxygenation for coronavirus disease 2019 patients: A systematic review and meta-analysis

“…Sixteen were multicenter observational studies, 21,22,24,26,29,30,36,40,41,45,47,[52][53][54]58,59 and three were prospective studies. 34,36,37 One was a randomized controlled trial.…”

“…Thirty-day mortality after ECMO implantation was reported in seven studies involving a total of 335 patients. 25,35,38,53,55,58,59 It varied from 18.8% to 63.0%, and the pooled 30-day mortality was 46% (95% CI 37%-57%, I 2 = 66%; Figure 2(a)). Four studies, involving 276 COVID-19 patients managed with ECMO, reported on 60-day mortality that varied from 13.3% to 80.8%.…”

Veno-Venous Extracorporeal Membrane Oxygenation terhadap Pemulihan Pasien COVID-19 Disertai Acute Respiratory Distress Syndrome

“…Kondisi ini membutuhkan suatu teknologi ekstrakorporeal yang dinamakan ECMO. ECMO dapat digunakan pada pasien COVID-19 yang disertai ARDS yang memenuhi syarat-syarat tertentu (Yankah et al, 2021). Selain itu, penggunaan ECMO dapat mencegah terjadinya kerusakan pada paru-paru yang diakibatkan oleh penggunaan ventilator.…”

Medical nutrition therapy in patients receiving ECMO: Evidence‐based guidance for clinical practice

“…Contemporary critical illness has ushered in a new era of mechanical circulatory support (MCS), such as venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VAD). Over the past 2 years, the coronavirus disease 2019 (COVID‐19) pandemic has seen a steady increase in the use of MCS, with particular use of ECMO support within intensive care units (ICU) worldwide 1,2 . ECMO alone or in combination with other MCS is generally used as a bridge to lung and/or heart recovery, VAD support, or lung or heart transplantation 3 .…”

“…Over the past 2 years, the coronavirus disease 2019 (COVID-19) pandemic has seen a steady increase in the use of MCS, with particular use of ECMO support within intensive care units (ICU) worldwide. 1,2 ECMO alone or in combination with other MCS is generally used as a bridge to lung and/or heart recovery, VAD support, or lung or heart transplantation. 3 Table S1 provides an overview on specific indications for the use of VA-and VV-ECMO, respectively.…”