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
. 2023 Jan-Feb:57:243-249.
doi: 10.1016/j.hrtlng.2022.10.003. Epub 2022 Oct 20.

Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Hamid Yaqoob  1 , Daniel Greenberg  2 , Lawrence Huang  2 , Theresa Henson  3 , Areen Pitaktong  2 , Daniel Peneyra  2 , Philip J Spencer  4 , Ramin Malekan  5 , Joshua B Goldberg  5 , Masashi Kai  5 , Suguru Ohira  5 , Zhen Wang  6 , M Hassan Murad  6 , Dipak Chandy  3 , Oleg Epelbaum  3
Affiliations

Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Hamid Yaqoob et al. Heart Lung. 2023 Jan-Feb.

Abstract

Background: The COVID-19 pandemic has led to a boom in the use of V-V ECMO for ARDS secondary to COVID. Comparisons of outcomes of ECMO for COVID to ECMO for influenza have emerged. Very few comparisons of ECMO for COVID to ECMO for ARDS of all etiologies are available.

Objectives: To compare clinically important outcome measures in recipients of ECMO for COVID to those observed in recipients of ECMO for ARDS of other etiologies.

Methods: V-V ECMO recipients between March 2020 and March 2022 consisted exclusively of COVID patients and formed the COVID ECMO group. All patients who underwent V-V ECMO for ARDS between January 2014 and March 2020 were eligible for analysis as the non-COVID ECMO comparator group. The primary outcome was survival to hospital discharge. Secondary outcomes included ECMO decannulation, ECMO duration >30 days, and serious complications.

Results: Thirty-six patients comprised the COVID ECMO group and were compared to 18 non-COVID ECMO patients. Survival to hospital discharge was not significantly different between the two groups (33% in COVID vs. 50% in non-COVID; p = 0.255) nor was there a significant difference in the rate of non-palliative ECMO decannulation. The proportion of patients connected to ECMO for >30 days was significantly higher in the COVID ECMO group: 69% vs. 17%; p = 0.001. There was no significant difference in serious complications.

Conclusion: This study could not identify a statistically significant difference in hospital survival and rate of successful ECMO decannulation between COVID ECMO and non-COVID ECMO patients. Prolonged ECMO may be more common in COVID. Complications were not significantly different.

Keywords: Acute respiratory distress syndrome; COVID-19; Extracorporeal membrane oxygenation; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest None of the authors has any relevant competing interest to disclose.

Figures

Fig 1
Fig. 1
Kaplan-Meier plot depicting the primary outcome of survival to hospital discharge in the two study groups.
Fig 2
Fig. 2
Diagram summarizing the outcomes of the two study groups. Figures in parentheses denote percentages relative to the total sample size in the respective group.
See this image and copyright information in PMC

References

    1. Ashbaugh D.G., Bigelow D.B., Petty T.L., Levine B.E. Acute respiratory distress in adults. Lancet. 1967;2:319–323. - PubMed
    1. Peek G.J., Mugford M., Tiruvoipati R., et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009;374:1351–1363. [published correction appears in Lancet. 2009 Oct 17;374(9698):1330] - PubMed
    1. Bellani G., Laffey J.G., Pham T., et al. epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315:788–800. [published correction appears in JAMA. 2016 Jul 19;316(3):350] [published correction appears in JAMA. 2016 Jul 19;316(3):350] - PubMed
    1. Combes A., Hajage D., Capellier G., et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018;378:1965–1975. - PubMed
    1. Goligher E.C., Tomlinson G., Hajage D., et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome and posterior probability of mortality benefit in a post hoc Bayesian analysis of a randomized clinical trial. JAMA. 2018;320:2251–2259. [published correction appears in JAMA. 2019 Jun 11;321(22):2245] - PubMed

MeSH terms