Venovenous extracorporeal membrane oxygenation for COVID-19 associated severe respiratory failure: Case series from a Hungarian tertiary centre

Perfusion. 2024 May;39(4):790-796. doi: 10.1177/02676591231160272. Epub 2023 Mar 13.

Abstract

Introduction: Venovenous extracorporeal membrane oxygenation (V-V ECMO) is recommended for the support of patients with severe COVID-19 associated severe respiratory failure (SRF). We report the characteristics and outcome of COVID-19 patients supported with V-V ECMO in a Hungarian centre.

Methods: We retrospectively collected data on all patients admitted with proven SARS CoV-2 infection who received V-V ECMO support between March 2021 and May 2022.

Results: Eighteen patients were placed on ECMO during this period, (5 women, age (mean ± SD) 44 ± 10 years, APACHE II score (median (interquartile range)) 12 (10-14.5)). Before ECMO support, they had been hospitalised for 6 (4-11) days. Fifteen patients received noninvasive ventilation for 4 (2-8) days, two patients had high flow nasal oxygen therapy, for one day each. They had already been intubated for 2.5 (1-6) days. Prone position was applied in 15 cases. On the day before ECMO initiation the Lung Injury Score was 3.25 (3-3.26), the PaO2/FiO2 ratio was 71 ± 19 mmHg. The duration of V-V ECMO support was 26 ± 20 days, and the longest run lasted 70 days. Patients were mechanically ventilated for 34 ± 23 days. The intensive care unit (ICU) and the hospital length of stay were 40 ± 28 days and 45 ± 31 days, respectively. Eleven patients were successfully weaned from ECMO. The ICU survival rate was 56%, the in-hospital survival was 50%. All patients who were discharged from hospital reported a good health-related quality of life Rankin score (0-2) at the 5-16 months follow-up.

Conclusions: During the last three waves of the COVID-19 pandemic, we achieved a 56% ICU and a 50% hospital survival rate at our low volume centre.

Keywords: COVID-19; extracorporeal membrane oxygenation; intensive care; respiratory support; severe hypoxemic respiratory failure.

MeSH terms

  • Adult
  • COVID-19* / complications
  • COVID-19* / mortality
  • COVID-19* / therapy
  • Extracorporeal Membrane Oxygenation* / methods
  • Female
  • Humans
  • Hungary
  • Male
  • Middle Aged
  • Respiratory Insufficiency* / therapy
  • Retrospective Studies
  • SARS-CoV-2*
  • Tertiary Care Centers*
  • Treatment Outcome