COVID-19 Outcomes of Venovenous Extracorporeal Membrane Oxygenation for Acute Respiratory Failure Vs Historical Cohort of Non-COVID-19 Viral Infections

Overview

Journal Perfusion

Publisher Sage Publications

Date 2022 Jun 2

PMID 35653427

Authors

Sagar B Dave

Ronald Rabinowitz

Aakash Shah

Ali Tabatabai

Samuel M Galvagno Jr

Michael A Mazzeffi

Raymond Rector

David J Kaczorowski

Thomas M Scalea

Jay Menaker

Affiliations

Soon will be listed here.

Abstract

Introduction: Veno-venous extracorporeal membrane oxygenation (VV ECMO) has become a support modality for patients with acute respiratory failure refractory to standard therapies. VV ECMO has been increasingly used during the current COVID-19 pandemic for patients with refractory respiratory failure. The object of this study was to evaluate the outcomes of VV ECMO in patients with COVID-19 compared to patients with non-COVID-19 viral infections.

Methods: We retrospectively reviewed all patients supported with VV ECMO between 8/2014 and 8/2020 whose etiology of illness was a viral pulmonary infection. The primary outcome of this study was to evaluate in-hospital mortality. The secondary outcomes included length of ECMO course, ventilator duration, hospital length of stay, incidence of adverse events through ECMO course.

Results: Eighty-nine patients were included (35 COVID-19 vs 54 non-COVID-19). Forty (74%) of the non-COVID-19 patients had influenza virus. Prior to cannulation, COVID-19 patients had longer ventilator duration (3 vs 1 day, = .003), higher PaCO (64 vs 53 mmHg, = .012), and white blood cell count (14 vs 9 ×10/μL, = .004). Overall in-hospital mortality was 33.7% ( = 30). COVID-19 patients had a higher mortality (49% vs. 24%, = .017) when compared to non-COVID-19 patients. COVID-19 survivors had longer median time on ECMO than non-COVID-19 survivors (24.4 vs 16.5 days = .03) but had a similar hospital length of stay (HLOS) (41 vs 48 Extracorporeal Membrane Oxygenationdays = .33).

Conclusion: COVID-19 patients supported with VV ECMO have a higher mortality than non-COVID-19 patients. While COVID-19 survivors had significantly longer VV ECMO runs than non-COVID-19 survivors, HLOS was similar. This data add to a growing body of literature supporting the use of ECMO for potentially reversible causes of respiratory failure.

Citing Articles

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