J Chest Surg.  2024 Jan;57(1):36-43. 10.5090/jcs.23.102.

Outcomes of Extracorporeal Membrane Oxygenation in COVID-19: A Single-Center Study

• Kim S
• Lim JH
• Ko HH
• Lee HK
• Ra YJ
• Kim K
• Kim HS

• KMID: 2550619
• DOI: http://doi.org/10.5090/jcs.23.102

Abstract

Background
Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO.
Methods
Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality.
Results
Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5–61.5 years), compared to 64 years (IQR, 60.0–68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92–69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95–9,910.14; p=0.0233) were independent predictors of mortality.
Conclusion
Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

Keyword

COVID-19; Extracorporeal membrane oxygenation; Acute respiratory distress syndrome