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

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)243-249
Number of pages7
JournalHeart and Lung
Volume57
DOIs
StatePublished - Jan 1 2023

Keywords

  • Acute respiratory distress syndrome
  • COVID-19
  • Extracorporeal membrane oxygenation
  • SARS-CoV-2

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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