Adding another mechanical support system—extracorporeal membrane oxygenation, or ECMO—for patients with coronavirus disease 2019 (COVID-19) on ventilators resulted in 96 percent of patients surviving (4% mortality) over a 44-day period, an early study finds. Patients with this severity of disease often die, say the study authors, with another recent report finding the mortality rate to be 88.1% among patients with COVID-19 who are intubated.
Led by researchers at NYU Grossman School of Medicine, the study of 27 patients placed on ECMO found the high survival rate at the end of the study period, which ran from March 10 to April 24. Of the 321 patients intubated during that span, 27 were chosen to receive ECMO because the research team judged that it would give them a chance to survive otherwise frequently fatal respiratory failure. While critically ill, the included patients had neither life-threatening complications (such as blood clotting issues) nor the very lowest observed oxygen levels in their arteries (a PaO2/FiO2, or P/F, ratio of less than 60 mmHg).
Published online in The Annals of Thoracic Surgery, the study is the largest published single-center examination of ECMO, a specialized heart–lung bypass machine used when the lungs cannot function by themselves, in patients with severe COVID-19. The technique—which removes blood from the body, infuses it with oxygen, and returns it—is an intricately challenging process to manage, say the authors. Its many risks include bleeding complications and stroke, with only specialized centers having the capability to deliver it safely.