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Lessons Learned From Extracorporeal Life Support Practice and Outcomes During the COVID-19 Pandemic.

George Gill1, Michael O'Connor2, Mark E Nunnally3

  • 1Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

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Extracorporeal membrane oxygenation (ECMO) use expanded during COVID-19 for respiratory failure and shock. Careful patient selection and expert management are crucial for ECMO, especially as a bridge to transplantation.

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Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Pulmonology

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a vital support for hypoxemic respiratory failure and cardiogenic shock.
  • COVID-19 pandemic necessitated increased ECMO use for refractory cardiopulmonary disease.
  • ECMO served as a critical bridge to heart or lung transplantation for COVID-19 patients.

Purpose of the Study:

  • To review evidence supporting ECMO in COVID-19.
  • To describe ECMO practice and outcomes for COVID-19 related respiratory failure and cardiogenic shock.
  • To propose lessons for future public health emergencies.

Main Methods:

  • Literature review of ECMO use in COVID-19.
  • Analysis of practice patterns and patient outcomes.
  • Synthesis of expert recommendations and experiences.

Main Results:

  • ECMO use surged during the pandemic for severe COVID-19.
  • Careful patient selection and resource management were essential.
  • ECMO facilitated transplantation for select COVID-19 patients.

Conclusions:

  • ECMO played a significant role in managing critical COVID-19 patients.
  • Lessons learned emphasize the need for preparedness and expertise in mechanical circulatory support.
  • Optimizing ECMO implementation is key for future emergencies and bridging to transplantation.