Clinical outcomes of severe COVID-19 patients receiving early VV-ECMO and the impact of pre-ECMO ventilator use

Chandra Kunavarapu, Samrat Yeramaneni, Jairo Melo, Rachel K. Sterling, Lindsey C. Huskey, Lindsay Sears, Charles Burch, Steve M. Rodriguez, Phillip J. Habib, Fernando Triana, Jeffrey DellaVolpe

Research output: Contribution to journalArticlepeer-review

Abstract

Acute respiratory distress syndrome (ARDS) in COVID-19 patients is associated with poor clinical outcomes and high mortality rates, despite the use of mechanical ventilation. Veno-Venous Extracorporeal membrane Oxygenation (VV-ECMO) in these patients is a viable salvage therapy. We describe clinical outcomes and survival rates in 52 COVID-19 patients with ARDS treated with early VV-ECMO at a large, high-volume center ECMO program. Outcomes included arterial blood gases, respiratory parameters, inflammatory markers, adverse events, and survival rates. Patients’ mean age was 47.8 ± 12.1 years, 33% were female, and 75% were Hispanic. At the end of study period, 56% (n = 29) of the patients survived and were discharged and 44% (n = 23) of the patients expired. Survival rate was 75.0% (9 out of 12) in patients placed on ECMO prior to mechanical ventilation. Longer duration on mechanical ventilation prior to ECMO intervention was associated with a 31% (aOR = 1.31, 95% CI, 1.00–1.70) increased odds of mortality after adjusting for age, gender, BMI, number of comorbid conditions, and post-ECMO ventilator days. Early and effective ECMO intervention in critical ill COVID-19 patients might be a valuable strategy in critical care settings to increase their odds of survival.

Original languageEnglish (US)
Pages (from-to)861-867
Number of pages7
JournalInternational Journal of Artificial Organs
Volume44
Issue number11
DOIs
StatePublished - Nov 2021

Keywords

  • ARDS
  • COVID-19
  • awake ECMO
  • early ECMO
  • mechanical ventilation
  • mortality
  • observational

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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