Outcomes associated with prolonged ECMO in COVID-19 associated ARDS: A single center experience

• Published in: Perfusion Vol. 39; no. 6; p. 1213
• Main Authors: Shah, Purav, Miller, Casey, Parilla, Gustavo, Daneshmand, Mani, Creel-Bulos, Christina
• Format: Journal Article
• Language: English
• Published: England 01.09.2024
• Subjects: Adult; COVID-19 - complications; COVID-19 - mortality; COVID-19 - therapy; Extracorporeal Membrane Oxygenation - methods; Female; Humans; Male; Middle Aged; Respiratory Distress Syndrome - etiology; Respiratory Distress Syndrome - mortality; Respiratory Distress Syndrome - therapy; Respiratory Distress Syndrome - virology; Retrospective Studies; SARS-CoV-2; Time Factors; Treatment Outcome; COVID-19; ECMO; ARDS (MESH); survival; Transplant
• DOI: 10.1177/02676591231184710

The COVID-19 pandemic has led to a significant increase in the use of veno-venous extracorporeal membrane oxygenation (V-V ECMO) as a bridge to transplantation versus recovery. Unlike other etiologies of acute respiratory distress syndrome (ARDS), utilization of V-V ECMO in COVID-19 has been associated with longer duration of ECMO support requirements. Our team sought to evaluate outcomes associated with prolonged duration of ECMO support in this patient population. Single-center retrospective review of patients who were placed on ECMO due to COVID-19 associated ARDS. Specifically examining outcomes-transplant free survival, mortality and discharge rates-of patients requiring V-V ECMO support for greater than 50 days. The median age of the cohort was 48 years and 13 patients (72%) were males. The median duration of ECMO support was 84 days (IQR 55-106). 11 patients (61%) had right ventricular dysfunction and 13 patients (72%) had pneumothoraces. There was a 33% percent ( = 6) mortality rate within cohort. One patient continues to require ECMO support at time of abstract submission. 11 patients (61%) patients were discharged, of which 3 patients required a lung transplant. Prolonged V-V ECMO can be associated with comparable outcomes to conventional V-V ECMO runs that are relatively shorter in duration. With availability of device and staffing, prolonged ECMO runs can potentially be justified in a highly selected patient population.