Extracorporeal membrane oxygenation (ECMO) may be used to treat COVID-19 patients with severe respiratory failure who are resistant to traditional therapy. Requiring ECMO was linked to increased mortality and a drawn-out hospital stay. With little information on integrating palliative care consultation (PCC), ECMO is a resource-intensive intervention that significantly strains caregivers and families. For a study, researchers sought to investigate the function of manual versus automatic PCC in treating COVID patients receiving ECMO.

A review and analysis of all COVID patients on ECMO who were hospitalized from March 2020 to May 2021 at a busy university medical facility was done.

The analysis comprised 48 patients in total. Twenty-six patients (54.2%) received PCC, with 42% of consults starting automatically. Any admission of PCC was linked to a longer stay on ECMO (24.5 vs. 37 days; P<0.05). Even though the results were not statistically significant, automatic PCC led to more family meetings than normal PCC (0 vs. 3; P<0.05) and seemed to be associated with shorter hospital stays, less time spent on ECMO, and higher DNAR rates at death. Indicating that complete intensive care measures lasted till death, decedents not receiving PCC showed higher rates of no de-escalation of treatments at the time of death (31% vs. 11%).

PCC may be linked to a change in DNAR status in COVID-19 patients undergoing ECMO, especially with automated PCC. The length of the stay, the time spent receiving ECMO, and the care plan at the end of life may also be affected.

Reference: jpsmjournal.com/article/S0885-3924(22)00789-8/fulltext