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Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
06:41

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Published on: October 24, 2018

Extracorporeal Membrane Oxygenation for COVID-19: Updated 2021 Guidelines from the Extracorporeal Life Support

Jenelle Badulak1,2, M Velia Antonini3,4, Christine M Stead5

  • 1From the Department of Emergency Medicine, University of Washington, Seattle, Washington.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|March 3, 2021
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) guidelines for COVID-19 patients are updated. Most patients use venovenous ECMO for ARDS, with similar mortality to non-COVID-19 cases, though data suggests increasing mortality.

Area of Science:

  • Critical Care Medicine
  • Cardiopulmonary Support
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) can cause severe cardiopulmonary failure.
  • Extracorporeal membrane oxygenation (ECMO) is a vital support for critical cases.
  • The Extracorporeal Life Support Organization (ELSO) provides updated guidelines for ECMO in COVID-19.

Purpose of the Study:

  • To provide updated guidelines for ECMO use in COVID-19 patients.
  • To outline selection criteria and management practices for ECMO in severe COVID-19.
  • To encourage data submission for further research on optimal ECMO use.

Main Methods:

  • Review of existing data on ECMO use in COVID-19 patients.
  • Analysis of patient outcomes, including run duration and mortality.
  • Consideration of resource constraints during pandemics.

Main Results:

  • Over 90% of COVID-19 patients requiring ECMO utilize venovenous (V-V) ECMO for acute respiratory distress syndrome (ARDS).
  • Published mortality for COVID-19 ECMO patients appears similar to non-COVID-19 patients, but ongoing data suggests a potential increase.
  • Conventional ECMO selection criteria are recommended, with stricter contraindications during resource limitations.

Conclusions:

  • Standard ECMO selection and management practices are generally applicable to COVID-19 patients.
  • Regional ECMO networks can improve communication and resource sharing.
  • Continued data collection and participation are crucial for optimizing ECMO therapy in COVID-19 and related conditions like MIS-C in children.
Abstract

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