The following is a summary of “Role of ECMO in COVID-19 acute respiratory failure: Defining risk factors for mortality,” published in the JUNE 2023 issue of Surgery by Gallaher, et al.
During the COVID-19 pandemic, the use of venovenous extracorporeal membrane oxygenation (VV ECMO) substantially increased without established patient selection criteria. For a study, researchers sought to retrospectively review adult patients with COVID-19-associated acute respiratory distress syndrome (ARDS) who underwent VV ECMO, and identify factors associated with mortality.
A retrospective review was conducted on all adult patients with COVID-19-associated ARDS who received VV ECMO at the institution between April 2020 and June 2022. The study included 162 patients (n = 95 Pre-Delta; n = 58 Delta; n = 9 Omicron). The proportion of patients requiring ECMO for more than three weeks varied across pandemic periods (17% pre-Delta, 41% Delta, 22% Omicron, P = 0.003). The in-hospital mortality rate was 60.5%. Age ≥50 years (RR 1.28, 95% CI 1.01, 1.62), ≥7 days of respiratory support (RR 1.39, 95% CI 1.05, 1.83), and pre-cannulation renal failure requiring dialysis (RR 1.42, 95% CI 1.13, 1.78) were associated with increased mortality risk.
The study found that in VV ECMO patients with COVID-19, older age, longer duration of pre-ECMO respiratory support, and pre-ECMO renal failure were all associated with a higher risk of mortality, with an approximately 30% increased risk in each case.
Source: americanjournalofsurgery.com/article/S0002-9610(22)00799-1/fulltext