COVID-19 Patients Require Prolonged Extracorporeal Membrane Oxygenation Support for Survival Compared With Non-COVID-19 Patients

Martin Russ; Mario Menk; Jan Adriaan Graw; Vladimir Skrypnikov; Oliver Hunsicker; Kathleen Rudat; Steffen Weber-Carstens; Roland C E Francis; Philipp A Pickerodt

doi:10.1097/CCE.0000000000000671

COVID-19 Patients Require Prolonged Extracorporeal Membrane Oxygenation Support for Survival Compared With Non-COVID-19 Patients

Crit Care Explor. 2022 Mar 29;4(4):e0671. doi: 10.1097/CCE.0000000000000671. eCollection 2022 Apr.

Authors

Martin Russ¹, Mario Menk¹, Jan Adriaan Graw¹, Vladimir Skrypnikov¹, Oliver Hunsicker¹, Kathleen Rudat¹, Steffen Weber-Carstens¹, Roland C E Francis¹, Philipp A Pickerodt¹

Affiliation

¹ All authors: Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Abstract

To investigate the ICU survival of venovenous extracorporeal membrane oxygenation (ECMO) patients suffering from COVID-19-related acute respiratory distress syndrome (ARDS) versus ECMO patients without COVID-19 (non-COVID-19)-related ARDS.

Design: Preliminary analysis of data from two prospective ECMO trials and retrospective analysis of a cohort of ARDS ECMO patients.

Setting: Single-center ICU.

Patients: Adult ARDS ECMO patients, 16 COVID-19 versus 23 non-COVID-19 patients. Analysis of retrospective data from 346 adult ARDS ECMO patients.

Interventions: None.

Measurements and main results: COVID-19 and non-COVID-19 ARDS patients did not differ with respect to preexisting disease or body mass index. ICU survival rate was 62% for COVID-19 ECMO patients and 70% for non-COVID-19 ECMO patients. COVID-19 ECMO survivors were supported with ECMO for a median of 43 days (interquartile range [IQR], 18-58 d) versus 16 days (IQR, 19-39 d; p = 0.03) for non-COVID-19 patients. The median duration of ECMO therapy for all ARDS patients between 2007 and 2018 was 15 days (IQR, 6-28 d). The subgroup of patients suffering from any viral pneumonia received ECMO support for a median of 16 days (IQR, 9-27 d), survivors of influenza pneumonia received ECMO support for 13 days (IQR, 7-25 d).

Conclusions: COVID-19 patients required significant longer ECMO support compared with patients without COVID-19 to achieve successful ECMO weaning and ICU survival.

Keywords: COVID-19; duration of extracorporeal membrane oxygenation therapy; extracorporeal membrane oxygenation survival; pulmonary fibrotic remodeling; venovenous extracorporeal membrane oxygenation.