The Lancet
25 September, 2020

Ryan P Barbaro, MD, Graeme MacLaren, MBBS, Philip S Boonstra, PhD, Prof Theodore J Iwashyna, MD, Prof Arthur S Slutsky, MD, Eddy Fan, MD et al.

The severity of COVID-19-related acute hypoxaemic respiratory failure and clinical evidence supporting extracorporeal membrane oxygenation (ECMO) in the acute respiratory distress syndrome (ARDS) prompted several international organisations including the World Health Organization (WHO), Surviving Sepsis Campaign, and Extracorporeal Life Support Organization (ELSO) to consider a role for ECMO support during the current pandemic.WHO recommended that expert centres with sufficient ECMO volume to maintain proficiency consider ECMO support in COVID-19-related ARDS with refractory hypoxaemia if lung protective mechanical ventilation was insufficient to support the patient.Despite such optimism for a possible role for ECMO in both acute respiratory and cardiac failure, early reports of patients with COVID-19 requiring ECMO suggested that mortality could be greater than 90%. ELSO is an international organisation that maintains a registry of ECMO cases among its member centres. In March, 2020, the ELSO Registry augmented its data capture with an addendum designed for ECMO-supported patients with COVID-19 to obtain additional information on these patients. In this study, we used data from the ELSO Registry to report the epidemiology, treatment, outcomes, and hospital characteristics of patients receiving ECMO with a confirmed diagnosis of COVID-19. Additionally, we examined whether patient factors and historical hospital ECMO case volume were associated with in-hospital mortality.

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32008-0/fulltext