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The use of extracorporeal membrane oxygenation in COVID-19: a systematic review

  • 0Cardiology Department, Cardiovascular Diseases Institute "Prof. Dr. George I.M. Georgescu", University of Medicine and Pharmacy "Grigore T.Popa", Iași, Romania.
Archives of Medical Science : Ams +

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July 31, 2025

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July 31, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Extracorporeal membrane oxygenation (ECMO) may aid COVID-19 patients with ARDS, but outcomes vary widely. Further research is needed to understand its full impact and optimize its use in critical care settings.

Area Of Science

  • Critical Care Medicine
  • Cardiopulmonary Support
  • Infectious Diseases

Background

  • COVID-19 pandemic poses significant global health challenges, impacting health systems and economies.
  • SARS-CoV-2 infection can lead to multi-organ dysfunction, including acute respiratory distress syndrome (ARDS).
  • Mechanical circulatory support, like ECMO, is vital for maintaining organ perfusion during severe respiratory and cardiac compromise.

Purpose Of The Study

  • To systematically review and assess the impact of extracorporeal membrane oxygenation (ECMO) in patients with COVID-19 and ARDS.
  • To analyze comorbidities, side effects, and survival rates associated with ECMO use in this patient population.

Main Methods

  • A systematic literature review was conducted across major databases (PubMed, Web of Science, Embase, Cochrane, clinicaltrials.gov) from December 2019 to October 2021.
  • 33 studies involving 4760 COVID-19 patients treated with ECMO were included.
  • Data on patient comorbidities, adverse events, and survival to discharge were analyzed.

Main Results

  • Survival rates at discharge for COVID-19 patients on ECMO ranged significantly from 9% to 90.6%.
  • High incidences of adverse events were reported, including acute kidney injury (up to 87%), major bleeding (up to 92.1%), and strokes/cerebral hemorrhage (up to 34%).
  • Complications like pulmonary embolism, peripheral bleeding, and sepsis substantially impacted survival.

Conclusions

  • ECMO can serve as a critical rescue therapy for severe COVID-19 patients with ARDS.
  • Significant variability in study outcomes and incomplete understanding of SARS-CoV-2 mechanisms necessitate further research.
  • Optimization of ECMO protocols and patient selection is crucial for improving outcomes in COVID-19 critical care.

Keywords:

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