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Study: ECMO appears to help critically ill COVID-19 patients

Study supports use of ECMO in appropriate patients

Generic image of a hospital bed.
Generic image of a hospital bed. (Pixabay)

ANN ARBOR, Mich. – The life-support option known as ECMO appears to help many of the critically ill COVID-19 patients who received it, according to a study led by a University of Michigan researcher.

There were 1,035 patients in the study. Researchers said they faced a high risk of death, as ventilators and other care failed to support their lungs.

After they were placed on ECMO, their death rate was less than 40 percent. That’s similar to the rate for patients treated with ECMO in past outbreaks of lung-damaging viruses and other severe forms of viral pneumonia.

ECMO channels blood out of the body and into a circuit of equipment that adds oxygen directly to the blood before pumping it back into regular circulation.

“These results from hospitals experienced in providing ECMO are similar to past reports of ECMO-supported patients, with other forms of acute respiratory distress syndrome or viral pneumonia,” said co-lead author Ryan Barbaro of Michigan Medicine, U-M’s academic medical center. “These results support recommendations to consider ECMO in COVID-19 if the ventilator is failing. We hope these findings help hospitals make decisions about this resource-intensive option.”

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Co-lead author Graeme MacLaren of the National University Health System in Singapore said most centers in the study did not need to use ECMO for COVID-19 very often.

“Our findings also show that mortality risk rises significantly with patient age, and that those who are immunocompromised, have acute kidney injuries, worse ventilator outcomes or COVID-19-related cardiac arrests are less likely to survive,” said Barbaro, who chairs ELSO’s COVID-19 registry committee and provides ECMO care as a pediatric intensive care physician at U-M’s C.S. Mott Children’s Hospital.

More than half the patients int he study were treated in hospitals in the United States and Canada, including Michigan Medicine’s hospitals.

“ECMO is the final step in the algorithm for managing life-threatening lung failure in advanced ICUs,” U-M’s Robert Bartlett, emeritus professor of surgery and a co-author of the new paper said. “Now we know it is effective in COVID-19.”

As of Aug. 5, 380 of the patients int he study had died in the hospital. More than 80 percent of them within 24 hours of a proactive decision to discontinue ECMO care because of a poor prognosis.

Of the remaining patients 311 went home or to a rehabilitation center. There were 277 who had been discharged to another hospital or long-term acute care center. The rest were still in the hospital but had reached 90 days after the start of ECMO.

The new study added to the information used to create the ECMO COVID-19 guidelines published by ELSO.

Click here to read the study.


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