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ASAIO J
. 2021 Mar 1;67(3):245-249.
doi: 10.1097/MAT.0000000000001376.
Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Crisis Standards of Care
Cara Agerstrand 1 , Richard Dubois 2 , Koji Takeda 3 , Nir Uriel 4 , Philippe Lemaitre 3 , Justin Fried 4 , Amirali Masoumi 4 , Eva W Cheung 5 , Yuji Kaku 3 , Lucas Witer 3 , Peter Liou 2 , Claire Gerall 6 , Rafael Klein-Cloud 6 , Darryl Abrams 1 , Jennifer Cunningham 1 , Purnema Madahar 1 , Madhavi Parekh 1 , Briana Short 1 , Natalie H Yip 1 , Alexis Serra 1 , James Beck 7 , Michael Brewer 7 , Kenmund Fung 7 , Dana Mullin 7 , Roy Oommen 3 , Bryan Payne Stanifer 3 , William Middlesworth 6 , Joshua Sonett 3 , Daniel Brodie 1
Affiliations
- PMID: 33627596
- DOI: 10.1097/MAT.0000000000001376
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed extraordinary strain on global healthcare systems. Use of extracorporeal membrane oxygenation (ECMO) for patients with severe respiratory or cardiac failure attributed to COVID-19 has been debated due to uncertain survival benefit and the resources required to safely deliver ECMO support. We retrospectively investigated adult patients supported with ECMO for COVID-19 at our institution during the first 80 days following New York City's declaration of a state of emergency. The primary objective was to evaluate survival outcomes in patients supported with ECMO for COVID-19 and describe the programmatic adaptations made in response to pandemic-related crisis conditions. Twenty-two patients with COVID-19 were placed on ECMO during the study period. Median age was 52 years and 18 (81.8%) were male. Twenty-one patients (95.4%) had severe ARDS and seven (31.8%) had cardiac failure. Fifteen patients (68.1%) were managed with venovenous ECMO while 7 (31.8%) required arterial support. Twelve patients (54.5%) were transported on ECMO from external institutions. Twelve patients were discharged alive from the hospital (54.5%). Extracorporeal membrane oxygenation was used successfully in patients with respiratory and cardiac failure due to COVID-19. The continued use of ECMO, including ECMO transport, during crisis conditions was possible even at the height of the COVID-19 pandemic.