Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2021 Aug;36(8):910-917.
doi: 10.1177/08850666211007063. Epub 2021 Apr 7.

Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study

Senta Jorinde Raasveld  1 , Thijs S R Delnoij  2   3 , Lars M Broman  4 , Annemieke Oude Lansink-Hartgring  5 , Greet Hermans  6   7 , Erwin De Troy  8 , Fabio S Taccone  9 , Manuel Quintana Diaz  10 , Franciska van der Velde  11 , Dinis Dos Reis Miranda  12 , Erik Scholten  13 ; ETALON Study Group; Alexander P J Vlaar  1
Affiliations
Comparative Study

Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study

Senta Jorinde Raasveld et al. J Intensive Care Med. 2021 Aug.

Abstract

Background: To report and compare the characteristics and outcomes of COVID-19 patients on extracorporeal membrane oxygenation (ECMO) to non-COVID-19 acute respiratory distress syndrome (ARDS) patients on ECMO.

Methods: We performed an international retrospective study of COVID-19 patients on ECMO from 13 intensive care units from March 1 to April 30, 2020. Demographic data, ECMO characteristics and clinical outcomes were collected. The primary outcome was to assess the complication rate and 28-day mortality; the secondary outcome was to compare patient and ECMO characteristics between COVID-19 patients on ECMO and non-COVID-19 related ARDS patients on ECMO (non-COVID-19; January 1, 2018 until July 31, 2019).

Results: During the study period 71 COVID-19 patients received ECMO, mostly veno-venous, for a median duration of 13 days (IQR 7-20). ECMO was initiated at 5 days (IQR 3-10) following invasive mechanical ventilation. Median PaO2/FiO2 ratio prior to initiation of ECMO was similar in COVID-19 patients (58 mmHg [IQR 46-76]) and non-COVID-19 patients (53 mmHg [IQR 44-66]), the latter consisting of 48 patients. 28-day mortality was 37% in COVID-19 patients and 27% in non-COVID-19 patients. However, Kaplan-Meier curves showed that after a 100-day follow-up this non-significant difference resolves. Non-surviving COVID-19 patients were more acidotic prior to initiation ECMO, had a shorter ECMO run and fewer received muscle paralysis compared to survivors.

Conclusions: No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19.

Keywords: ARDS; COVID-19; ECMO; survival.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan-Meier estimates for patients with COVID-19 on ECMO and patients with ARDS not due to COVID-19 on ECMO. Unadjusted hazard ratio and 95% confidence interval calculated from a Cox proportional hazard model is presented.
See this image and copyright information in PMC

References

    1. WHO—Novel Coronavirus 2019—Events as they happen. Accessed April 27, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-a....
    1. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at John Hopkins University (JHU). Accessed September 22, 2020. https://coronavirus.jhu.edu/map.html - PMC - PubMed
    1. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324(8):782–793. doi:10.1001/jama.2020.12839 - PubMed
    1. Brogan T V, Lequier L, Lorusso R, MacLaren G, Peek G. Extracorporal Life Support: The ELSO Red Book. ELSO; 2017.
    1. Combes A, Hajage D, Capellier G, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018;378(21):1965–1975. doi:10.1056/NEJMoa1800385 - PubMed