Even before the pandemic, there was intense debate about whether ECMO was just an expensive "bridge to nowhere" for most patients - Blake Farmer
image by: Medical City Dallas Hospital
ECMO During Respiratory Pandemics: Past, Present, and Future
The role of extracorporeal membrane oxygenation (ECMO) in the management of severe acute respiratory failure, including the acute respiratory distress syndrome, has become better defined in recent years in light of emerging high-quality evidence and technological advances. Utilization of ECMO has consequently increased throughout many parts of the world.
The coronavirus disease 2019 (COVID-19) pandemic, however, has highlighted deficiencies in organizational capacity, research capability, knowledge sharing and resource utilization. While governments, medical societies, hospital systems and clinicians were collectively unprepared for the scope of this pandemic, the use…
ECMO in COVID-19: do not blame the tool
ECMO is not a treatment or a therapy, it simply supports patients with failing lungs, providing time for lung recovery or—exceptionally—to be bridged to lung transplantation.
ECMO therapy cuts Covid-19 patients' chance of dying by half, if they can get it
Among the group that received ECMO, 43% died in the hospital, while 89% of the patients who couldn't be transferred, 49 out of 55, died. "So among this very narrow group of people, these young people with few health problems who were really sick, it cut the risk of dying by about half," Casey said.
Doctors are shocked so many ICU patients are on this advanced life support right now
ECMO can be connected to the patient in two main ways: veno-venous (to replace just the function of the patient’s lungs) and veno-arterial (to do the work of both the heart and lungs).
ECMO during the COVID-19 pandemic: When is it justified?
ECMO is a complex supportive treatment with inherent complications and significant economic implications. ECMO should only be considered when proven effective and relatively inexpensive measures such as proning, neuromuscular blockade and lung-protective ventilation have been tried without success. Omitting these steps without a valid reason prior to ECMO commencement is unjustified and a disservice to the global ECMO community.
ECMO in COVID-19 Patients: A Systematic Review and Meta-analysis
The results suggested that ECMO could be advantageous for patients with COVID-19 with ARDS. The mortality rate for patients with ARDS due to COVID who received ECMO support was 39%...
ECMO in the COVID-19 Era: Looking Beyond the Guidelines
While we await a definitive answer on the overwhelming superiority of this modality over established ventilation strategies and other adjuncts, the decision to initiate extracorporeal support should be taken with great caution and with multidisciplinary input.
ECMO offers sickest COVID patients a chance to survive, but a slimmer one than previously thought
New findings show importance of carefully selecting patients for a critical care treatment requiring intense staffing, specialized equipment and advanced expertise.
ECMO: How This Respiratory Machine Can Effectively Treat COVID-19 Patients
“COVID-19 is different from pneumonia or an influenza A or B because it affects all five lobes of the lung — three on the right and two on the left — and it’s patchy and diffused throughout the whole lung,” Dr. Durham said. “That is where the real respiratory issues come from, as it’s damaging all areas of the lung.”
Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis
The outcomes from VV ECMO use in patients with COVID-19-related severe ARDS during the early pandemic appear similar to those reported in patients who receive VV ECMO for non-COVID-19-related severe ARDS.
How a Zoom forum is changing the way ICU doctors treat desperately ill Covid-19 patients
Other doctors noted that the drain on staffing is a major concern with ECMO. In an interview, Advent Health’s Silvestry said if he has four Covid-19 patients on ECMO, he needs eight nurses to care for them. But it requires just two or three nurses to care for eight Covid-19 patients who don’t need the technology to survive.
In Critical Coronavirus Cases, Doctors Turn to Last-Ditch Lung Support
It is a costly and labor-intensive way of replacing what lungs are supposed to do, making it a poor fit for hospitals now overwhelmed with patients suffering from lung disease. But doctors say the coronavirus pandemic is in some cases highlighting the value of extracorporeal membrane oxygenation, or ECMO.
Multi-institutional Analysis of 505 COVID-19 Patients Supported with ECMO: Predictors of Survival
ECMO facilitates salvage and survival of select critically ill patients with COVID-19. Survivors tend to be younger and have shorter time from diagnosis to intubation. Survival of patients supported with only veno-venous ECMO was 39.5%.
One in six most critically ill NHS Covid patients are unvaccinated pregnant women
Experts in pregnancy and women’s health, NHS leaders and ministers have been concerned at the number of mothers-to-be who have not been immunised, amid unfounded fears – partly fuelled by anti-vax campaigners – that getting jabbed could harm the mother, her baby or both. Those given Ecmo treatment have often failed to respond after being placed on a mechanical ventilator.
The Rationing of a Last-Resort Covid Treatment
While ventilator shortages have been largely averted in the U.S., this lifesaving therapy is scarce. How to choose which critically ill patients get it?
Too Young to Die
ECMO involves sensitive timing. Start the intensive treatment too early and lesser therapies might not have been given a chance to work. Start it too late and damage might be too extensive for the body to overcome.
When A Ventilator Isn’t Enough, Covid-19 Patients Are Being Placed On ECMO
Being placed on ECMO is extremely risky, but can be lifesaving in the right hands and in a facility with high level of expertise in ECMO care.
ECMO During Respiratory Pandemics: Past, Present, and Future
While governments, medical societies, hospital systems and clinicians were collectively unprepared for the scope of this pandemic, the use of ECMO – a highly resource-intensive and specialized form of life support – presented specific logistical and ethical challenges.
ELSO is providing this website as a resource for centers who may be called on to manage COVID-19 patients. As this is an emerging infectious disease, the scientific data is constantly evolving.
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Last Updated : Sunday, February 27, 2022