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. 2022 Mar 29;4(4):e0671.
doi: 10.1097/CCE.0000000000000671. eCollection 2022 Apr.

COVID-19 Patients Require Prolonged Extracorporeal Membrane Oxygenation Support for Survival Compared With Non-COVID-19 Patients

Martin Russ  1 , Mario Menk  1 , Jan Adriaan Graw  1 , Vladimir Skrypnikov  1 , Oliver Hunsicker  1 , Kathleen Rudat  1 , Steffen Weber-Carstens  1 , Roland C E Francis  1 , Philipp A Pickerodt  1
Affiliations

COVID-19 Patients Require Prolonged Extracorporeal Membrane Oxygenation Support for Survival Compared With Non-COVID-19 Patients

Martin Russ et al. Crit Care Explor. .

Abstract

To investigate the ICU survival of venovenous extracorporeal membrane oxygenation (ECMO) patients suffering from COVID-19-related acute respiratory distress syndrome (ARDS) versus ECMO patients without COVID-19 (non-COVID-19)-related ARDS.

Design: Preliminary analysis of data from two prospective ECMO trials and retrospective analysis of a cohort of ARDS ECMO patients.

Setting: Single-center ICU.

Patients: Adult ARDS ECMO patients, 16 COVID-19 versus 23 non-COVID-19 patients. Analysis of retrospective data from 346 adult ARDS ECMO patients.

Interventions: None.

Measurements and main results: COVID-19 and non-COVID-19 ARDS patients did not differ with respect to preexisting disease or body mass index. ICU survival rate was 62% for COVID-19 ECMO patients and 70% for non-COVID-19 ECMO patients. COVID-19 ECMO survivors were supported with ECMO for a median of 43 days (interquartile range [IQR], 18-58 d) versus 16 days (IQR, 19-39 d; p = 0.03) for non-COVID-19 patients. The median duration of ECMO therapy for all ARDS patients between 2007 and 2018 was 15 days (IQR, 6-28 d). The subgroup of patients suffering from any viral pneumonia received ECMO support for a median of 16 days (IQR, 9-27 d), survivors of influenza pneumonia received ECMO support for 13 days (IQR, 7-25 d).

Conclusions: COVID-19 patients required significant longer ECMO support compared with patients without COVID-19 to achieve successful ECMO weaning and ICU survival.

Keywords: COVID-19; duration of extracorporeal membrane oxygenation therapy; extracorporeal membrane oxygenation survival; pulmonary fibrotic remodeling; venovenous extracorporeal membrane oxygenation.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Probability of extracorporeal membrane oxygenation (ECMO) support over time with respect to the primary cause of acute respiratory distress syndrome (ARDS). Kaplan-Meier curves of the probability of continued venovenous ECMO support for patients with COVID-19 infection (COVID-19) (A) versus patients without COVID-19 infection (non-COVID-19) (B) after exclusion of one non-COVID-19 patient who was bridged to lung transplantation for 71 d with awake ECMO. C, Probability for non-COVID-19 ECMO patients with viral pneumonia versus non-COVID-19 ECMO patients with ARDS without viral pneumonia (D) for non-COVID-19 ECMO survivors with influenza versus non-COVID-19 ECMO survivors with community-acquired bacterial pneumonia. Comparisons were performed with the log-rank test.
See this image and copyright information in PMC

References

    1. World Health Organization: Weekly Epidemiological Update on COVID-19. 2021. Available at: https://www.who.int/publications/m/item/weekly-epidemiological-update-on.... Accessed August 20, 2021
    1. Extracorporeal Life Support Organization: Extracorporeal Life Support Organization (ELSO) Registry. 2021. Available at: https://www.elso.org/. Accessed August 27, 2021
    1. Henry BM, Lippi G: Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): Pooled analysis of early reports. J Crit Care 2020; 58:27–28 - PMC - PubMed
    1. Barbaro RP, MacLaren G, Boonstra PS, et al. ; Extracorporeal Life Support Organization: Extracorporeal membrane oxygenation support in COVID-19: An international cohort study of the Extracorporeal Life Support Organization registry. Lancet 2020; 396:1071–1078 - PMC - PubMed
    1. George PM, Wells AU, Jenkins RG: Pulmonary fibrosis and COVID-19: The potential role for antifibrotic therapy. Lancet Respir Med 2020; 8:807–815 - PMC - PubMed