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
. 2022 Dec:12:211-220.
doi: 10.1016/j.xjon.2022.08.007. Epub 2022 Sep 8.

Venovenous extracorporeal membrane oxygenation support in patients with COVID-19 respiratory failure: A multicenter study

Navin G Vigneshwar  1 , Muhammad F Masood  2 , Ivana Vasic  3 , Martin Krause  4 , Karsten Bartels  5 , Mark T Lucas  1 , Michael Bronsert  6 , Craig H Selzman  7 , Shaun Thompson  5 , Jessica Y Rove  1 , Thomas B Reece  1 , Joseph C Cleveland  1 , Jay D Pal  1 , David A Fullerton  1 , Muhammad Aftab  1
Affiliations

Venovenous extracorporeal membrane oxygenation support in patients with COVID-19 respiratory failure: A multicenter study

Navin G Vigneshwar et al. JTCVS Open. 2022 Dec.

Abstract

Objective: The COVID-19 pandemic presents a high mortality rate amongst patients who develop severe acute respiratory distress syndrome (ARDS). The purpose of this study was to evaluate the outcomes of venovenous extracorporeal membrane oxygenation (VV-ECMO) in COVID-19-related ARDS and identify the patients who benefit the most from this procedure.

Methods: Adult patients with COVID-19 and severe ARDS requiring VV-ECMO support at 4 academic institutions between March and October 2020 were included. Data were collected through retrospective chart reviews. Bivariate and multivariable analyses were performed with the primary outcome of in-hospital mortality.

Results: Fifty-one consecutive patients underwent VV-ECMO with a mean age of 50.4 years; 64.7% were men. Survival to hospital discharge was 62.8%. Median intensive care unit and hospitalization duration were 27.4 days (interquartile range [IQR], 17-37 days) and 34.5 days (IQR, 23-43 days), respectively. Survivors and nonsurvivors had a median ECMO cannulation time of 11 days (IQR, 8-18) and 17 days (IQR, 12-25 days). The average postdecannulation length of stay was 17.5 days (IQR, 12.4-25 days) for survivors and 0 days for nonsurvivors (IQR, 0-6 days). Only 1 nonsurvivor was able to be decannulated. Clinical characteristics associated with mortality between nonsurviors and survivors included increasing age (P = .0048), hemorrhagic stroke (P = .0014), and postoperative dialysis (P = .0013) were associated with mortality in a bivariate model and retained statistical significance in a multivariable model.

Conclusions: This multicenter study confirms the effectiveness of VV-ECMO in selected critically ill patients with COVID-19-related severe ARDS. The survival of these patients is comparable to non-COVID-19-related ARDS.

Keywords: ARDS, acute respiratory distress syndrome; COVID-19 infection; ELSO, Extracorporeal Life Support Organization; EOLIA, ECMO to Rescue Lung Injury in Severe ARDS; VV-ECMO; VV-ECMO, venovenous extracorporeal membrane oxygenation; mechanical support; proBNP, B-type natriuretic peptide; respiratory failure; severe ARDS.

PubMed Disclaimer

Figures

None
Graphical abstract
None
Venovenous extracorporeal membrane oxygenation in acute respiratory distress syndrome. The outcomes of patients with COVID-19 patients undergoing VV-ECMO are favorable, and survival is comparable to patients without COVID-19 with ARDS. Clinical markers associated with mortality may help guide patient selection for VV-ECMO cannulation and prognostication.
Figure 1
Figure 1
The outcomes of patients with COVID-19 undergoing veno-venous extracorporeal membrane oxygenation (VV-ECMO) are favorable, and survival is comparable to patients without COVID-19 with acute respiratory distress syndrome (ARDS). Clinical markers associated with mortality may help guide patient selection for VV-ECMO cannulation and prognostication. COVID-19, Coronavirus disease 2019.
See this image and copyright information in PMC

References

    1. Grasselli G., Zangrillo A., Zanella A., Antonelli M., Cabrini L., Castelli A., et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323:1574–1581. - PMC - PubMed
    1. Yang X., Yu Y., Xu J., Shu H., Xia J., Liu H., et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8:475–481. - PMC - PubMed
    1. Richardson S., Hirsch J.S., Narasimhan M., Crawford J.M., McGinn T., Davidson K.W., et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323:2052–2059. - PMC - PubMed
    1. Henry B.M., 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. Combes A., Hajage D., Capellier G., Demoule A., Lavoue S., Guervilly C., et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018;378:1965–1975. - PubMed