Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID‐19): A retrospective cohort study

Abstract

Purpose: The role of extracorporeal membrane oxygenatio (ECMO) for rescue therapy of respiratory failure in critically ill coronavirus disease 2019 patients remains controversial. We aimed to evaluate the clinical outcomes of ECMO in the treatment of COVID-19 compared with conventional ventilation support. Methods: In this retrospective cohort study, data were collected on extremely critical patients with COVID-19 from January 2020 to March 2020 in intensive care unit of a hospital in charge by national rescue team in Wuhan, China, the epicenter of pandemic. Patients were classified into the ECMO group and the conventional ventilation non-ECMO group. Clinical characteristics, technical characteristics, laboratory results, mortality, and complications of the two groups were analyzed. Results: 88 patients with extremely critical COVID-19 were screened; 34 received ECMO support and 31 received conventional ventilation support. Both groups had comparable characteristics at baseline in terms of age, gender, and comorbidities.Before ECMO or conventional therapy, patients in the two groups had sever acute respiratory distress syndrome with a mean partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio of 69.6 and 75.4, respectively. At the time of reporting, patients in the ECMO had significantly lower in-hospital mortality compared with the control group (58.8 vs. 93.5%, p = .001). Conclusion:ECMO is shown to decrease the mortality of extremely critical ill COVID-19 patients compared with the conventional treatment. Although complications occurred frequently, ECMO could still be a rescue therapy for the treatment of COVID-19 during the pandemic.

Evolving outcomes of extracorporeal membrane oxygenation during the first 2 years of the COVID-19 pandemic: a systematic review and meta-analysis

“…1 , Additional file 1 : Table S4) [ 3 , 5 , 16 – 65 ]. All studies were retrospective and observational in nature; 22 studies were conducted by studies centres from Europe [ 5 , 17 , 19 , 23 , 27 , 29 , 31 – 34 , 36 , 39 , 42 , 43 , 45 , 46 , 50 , 55 , 56 , 60 , 63 , 65 ], 17 from North America [ 16 , 18 , 20 – 22 , 24 , 25 , 37 , 40 , 47 , 48 , 52 – 54 , 57 , 58 , 61 ], 6 from the Asia–Pacific [ 26 , 28 , 35 , 38 , 41 , 44 ], 2 from South-West Asia and Africa,[ 51 , 62 ] 2 from Latin America [ 30 , 64 ], and 3 were studies conducted by centres from multiple ELSO regions [ 3 , 49 , 59 ], of which 2 were based on registry data [ 3 , 49 ]. The pooled age was 52.5 years (95% CI 50.7 to 54.3), and the majority of patients were male (75.0%, 95% CI 72.4% to 77.4%) and obese (BMI: 31.0, 95% CI 30.2 to 31.8).…”

Temporary mechanical circulatory support for COVID‐19 patients: A systematic review of literature

“…Fourteen studies (50%) reported data on possible cardiac causes of dea th. 33,34,37,40,45,48,53,54,56,58,59,61,62,71 Overall, a group of 71 patients were identified as dead from cardiac-related causes, such as tamponade, 33,40 heart failure, 37,48,62,69 cardiogenic shock, 69 or cardiac arrest 34 (Table 1).…”

Letter to the Editor: Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID‐19): A retrospective cohort study

“…1 Pontificia Universidad Católica del Ecuador, Quito, Ecuador Universidad de las Américas-Ecuador, Quito, Ecuador Email: aclteran@gmail.com…”

“…To the Editor, We have read the article "Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID-19): A retrospective cohort study" by Li et al 1 It was felicitous to go through this article, and we hereby applaud the author's efforts. We recognize the conclusion of the study that extracorporeal membrane oxygenation tends to minimize mortality in extremely ill COVID-19 patients compared to the conventional approach.…”