The Use of Extracorporeal Membrane Oxygenation for COVID-19: Lessons Learned

Madhavi Parekh; Darryl Abrams; Cara Agerstrand; Jenelle Badulak; Amy Dzierba; Peta M A Alexander; Susanna Price; Eddy Fan; Dana Mullin; Rodrigo Diaz; Carol Hodgson; Daniel Brodie

doi:10.1016/j.ccm.2022.11.016

The Use of Extracorporeal Membrane Oxygenation for COVID-19: Lessons Learned

Clin Chest Med. 2023 Jun;44(2):335-346. doi: 10.1016/j.ccm.2022.11.016. Epub 2022 Nov 29.

Authors

Affiliations

¹ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 622 West 168th Street, PH8-101, New York, NY 10023, USA. Electronic address: mp2654@cumc.columbia.edu.
² Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 622 West 168th Street, PH8-101, New York, NY 10023, USA.
³ Department of Emergency Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, 4408 S Holly Street, Seattle, WA 98118, USA.
⁴ Department of Pharmacy, NewYork-Presbyterian Hospital, 622 West 168th Street, VC Basement (pharmacy), New York, NY 10032, USA.
⁵ Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
⁶ Royal Brompton & Harefield Hospitals, Guys and St Thomas's NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK; National Heart and Lung Institute, Imperial College, London, UK.
⁷ Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto General Hospital, 585 University Avenue, 9-MaRS-9013, Toronto, Ontario, M5G 2N2, Canada.
⁸ Department of Clinical Perfusion and Anesthesia Support Services, NewYork-Presbyterian Hospital, New York, NY, USA.
⁹ Clinica Las Condes, Clinica Red Salud Santiago CCHC, Camino El Cajon 18274, casa 5, Lo Barnechea, Santiago, 7710260, Chile.
¹⁰ Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care-Research Centre, Monash University, 3/553 Street Kilda Road, Melbourne 3004, Australia; Department of Intensive Care, Alfred Health, Melbourne, Australia.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has seen an increase in global cases of severe acute respiratory distress syndrome (ARDS), with a concomitant increased demand for extracorporeal membrane oxygenation (ECMO). Outcomes of patients with severe ARDS due to COVID-19 infection receiving ECMO support are evolving. The need for surge capacity, practical and ethical limitations on implementing ECMO, and the prolonged duration of ECMO support in patients with COVID-19-related ARDS has revealed limitations in organization and resource utilization. Coordination of efforts at multiple levels, from research to implementation, resulted in numerous innovations in the delivery of ECMO.

Keywords: ARDS; Acute respiratory distress syndrome; COVID-19; ECMO; Respiratory failure.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / therapy
Extracorporeal Membrane Oxygenation* / methods
Humans
Pandemics
Respiratory Distress Syndrome* / etiology
Respiratory Distress Syndrome* / therapy