Extracorporeal Membrane Oxygenation in Patients With COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) is characterized by a clinical spectrum of diseases ranging from asymptomatic or mild cases to severe pneumonia with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has been used as rescue therapy in appropriate patients with COVID-19 complicated by ARDS refractory to mechanical ventilation. In this study, we review the indications, challenges, complications, and clinical outcomes of ECMO utilization in critically ill patients with COVID-19-related ARDS. Most of these patients required venovenous ECMO. Although the risk of mortality and complications is very high among patients with COVID-19 requiring ECMO, it is similar to that of non-COVID-19 patients with ARDS requiring ECMO. ECMO is a resource-intensive therapy, with an inherent risk of complications, which makes its availability limited and its use challenging in the midst of a pandemic. Well-maintained data registries, with timely reporting of outcomes and evidence-based clinical guidelines, are necessary for the careful allocation of resources and for the development of standardized utilization protocols.

The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2, Part 9: The Worst Is Over?

“…2 The use of extracorporeal membrane oxygenation (ECMO) as a treatment in severely ill patients dramatized the importance of advanced intensive care approaches in improving survival rates. 3…”

“…2 The use of extracorporeal membrane oxygenation (ECMO) as a treatment in severely ill patients dramatized the importance of advanced intensive care approaches in improving survival rates. 3 Perhaps, the greatest success in helping to manage the pandemic was the development of a vaccine and various antiviral agents. 4 Again, the use of the vaccine became a political issue, with differences in its application being debated according to political party, race, and misinformation on the internet.…”

The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus 2, Part 7: COVID-19, What Next?

“…Second, Sreenivasin et al 6 report on the clinical experiences with extracorporeal membrane oxygenation as a reserve therapy for patients with severe Covid-19 infection, complicated by acute respiratory distress syndrome that is refractory to mechanical ventilation. The clinical outcomes in patients receiving extracorporeal membrane oxygenation appear to be similar to non-Covid patients who also receive this therapy.…”