ECLS | Extracorporeal Membrane Oxygenation

Registry Dashboard of ECMO-Supported COVID-19 Patient Data

Thank you for helping ELSO disseminate information by entering your experience in the ELSO Registry as soon as ECMO is implanted - before the run is complete. Instructions for entering data in the Registry and COVID-19 addendum can be found on the Data Definitions page.

We recognize you cannot complete and submit the entire ELSO Registry case report form prior to completion of the ECMO run and discharge from the hospital, but we would still like to have the data you know now.

To address concerns about incomplete data we report three nested data sets to accommodate the fact that different patients will be at different stages of care (and thus have more or less incomplete data). Also when considering the data please understand that the data displayed is a real-time data stream and subject to change as more patient information is accrued and as centers update the ELSO Registry Case Report Form and the ELSO COVID-19 addendum.



COVID-19 Cases on ECMO in the ELSO Registry

Total COVID-19 Cases COVID-19
Confirmed Cases
15,102
Total counts of COVID-19 confirmed patients.

COVID-19 ECMO counts by ELSO Chapter

Still on ECMO Still Hospitalized at ELSO Center Total (n)
All ELSO 560 859 15,164
          North America 185 293 9,772
          Europe 175 252 3,111
          Asia Pacific 32 49 302
          Latin America 124 187 989
          SWAAC 44 78 990
Reports counts of ECMO-supported suspected or confirmed COVID-19 cases by ELSO Chapter

Filters affect the data shown in the tables below:

Year To Date

Region

Patient Age


Patients who initiated ECMO at
least 90 days ago
COVID-19
Confirmed
444
COVID-19
In-hospital Mortality
30%

Outcomes

Pre-ECMO Patient Factors

Patient-level summaries of COVID ECMO runs. All categorical variables are given as 'percentage (count)'
Total ARDS Cohort
Number cases 444 161
Age(years)
Median(IQR) 10(1,16) 14(2,17)
# observed 444 161
BMI, kg/m2
Median(IQR) 25(17,37) 33(22,42)
# observed 386 144
Sex
Male 49%(217) 50%(80)
Female 51%(227) 50%(81)
# observed 444 161
Race/Ethnicity
Black 21%(92) 16%(25)
White (Non-Hispanic) 37%(165) 38%(61)
Asian 4%(18) 5%(8)
Mid East, N African 2%(11) 5%(8)
Other 2%(11) 2%(4)
Unknown 4%(19) 4%(7)
Multiple 3%(14) 4%(6)
Hispanic 26%(114) 26%(42)
# observed 444 161
Pre-ECMO Comorbidities
No comorbidity 43%(189) 34%(55)
Cancer 3%(12) 2%(4)
Pregnancy 1%(3) 1%(2)
Immunocompromised 7%(30) 6%(10)
Diabetes 9%(38) 12%(20)
Pre-existing heart disease 7%(31) 1%(1)
Pre-existing lung disease 5%(22) 6%(9)
Pre-existing renal insuff. 2%(7) 1%(1)
Frailty 2%(7) 1%(2)
Asthma 14%(61) 18%(29)
BMI $> 30 \mathrm{kg}/\mathrm{m}^2$ 33%(145) 50%(80)
Hypertension 7%(29) 12%(19)
# observed 444 161
Acute illness
ARDS 53%(235) 100%(161)
Acute heart failure 20%(87) 4%(6)
Myocarditis 12%(54) 0%(0)
Acute kidney injury 18%(80) 18%(29)
# observed 444 161
Pre-ECMO Cardiac Arrest
Yes 19%(82) 3%(5)
No 81%(361) 97%(156)
# observed 443 161
Pre-ECMO Co-Infection
No Co-infection 53%(234) 50%(81)
Bacterial pneumonia 33%(146) 39%(62)
Co-viral infection 20%(90) 19%(31)
Blood stream infection 14%(61) 16%(26)
Urinary tract infection 5%(23) 10%(16)
# observed 444 161

Pre-ECMO Interventions

Support and therapies. All categorical variables are given as 'percentage (count)'
PreECLS PreECLS
Number cases 444 161
Noninvasive ventilation
Noninvasive ventilation prior to intubation 67%(296) 85%(137)
BiPAP 36%(158) 53%(86)
CPAP 10%(46) 12%(19)
HFNC 43%(192) 53%(85)
# observed 444 161
Pre-ECLS intubation (days)
Median(IQR) 0.7(0.2,3.0) 1.4(0.3,4.5)
# observed 374 141
Ventilator mode
Conventional 82%(323) 81%(121)
# observed 394 150
PEEP, cm H2O
Median(IQR) 12.0(8.0,15.0) 14.0(12.0,16.0)
# observed 305 115
PIP, cm H2O
Median(IQR) 32.0(25.0,37.0) 35.0(29.0,40.0)
# observed 273 101
FiO2
Median(IQR) 1.00(0.90,1.00) 1.00(0.94,1.00)
# observed 357 139
PaO2/FiO2
Median(IQR) 67(54,116) 64(54,86)
# observed 345 134
PCO2
Median(IQR) 53(42,69) 59(48,68)
# observed 372 144
Pre-ECMO Support
Prone positioning 20%(87) 36%(58)
# observed 444 161
Neuromuscular blockers 65%(288) 76%(122)
# observed 444 161
Inhaled pulmonary vasodilators 35%(157) 48%(77)
# observed 444 161
Any vasoactive support 63%(278) 56%(90)
# observed 444 161
Norepinephrine 31%(138) 33%(53)
# observed 444 161
Therapies, Immunomodulators
Any therapy 84%(372) 93%(150)
Glucocorticoids 73%(326) 84%(135)
IVIG 20%(88) 6%(10)
Anti-cytokine 24%(107) 22%(36)
Lopinavir/Ritonavir 1%(5) 2%(4)
JAK inhibition 2%(9) 3%(5)
Chloroquine/hydroxychloroquine 3%(12) 4%(7)
Remdesivir 50%(224) 60%(96)
# observed 444 161
Support type
Respiratory 70%(310) 100%(161)
Cardiac 24%(108) 0%(0)
ECPR 6%(26) 0%(0)
# observed 444 161

Patient Status & Complications

Outcomes
Total ARDS Cohort
Last known patient status
Discharged alive to home or acute rehabilitation 48%(213) 48%(77)
Discharged alive to long-term acute care or unspecified location 9%(39) 11%(18)
Discharged to another hospital 9%(40) 11%(18)
Remain in the hospital (discharged from ICU) 0%(2) 0%(0)
Remain in the ICU 2%(10) 2%(4)
In-hospital death 32%(140) 27%(44)
Tracheostomy 19%(81) 31%(47)
# observed 418 151
Select complications
Seizures 2%(10) 1%(2)
# observed 441 160
CNS infarction by US/CT/MRI 4%(17) 1%(1)
# observed 441 160
CNS hemorrhage by US/CT/MRI 4%(18) 4%(7)
# observed 441 160
Hemolysis 10%(44) 11%(18)
# observed 441 160
Oxygenator failure 10%(45) 18%(29)
# observed 441 160
Pump failure 2%(7) 1%(2)
# observed 441 160
Circuit change 12%(52) 14%(22)
# observed 441 160
Thrombosis/Clots in circuit component 5%(21) 8%(12)
# observed 441 160
Discharge location
Home 59%(171) 51%(58)
Transfer to LTAC or Rehab
Transfer to another hospital 14%(40) 16%(18)
Other/Unknown 8%(22) 6%(7)
*N/A - Data elements with n<5 are not displayed.

ELSO Ownership, No Rights to Publication, Disclaimer

The Dashboard content has been compiled and reported from a variety of sources, is not independently verified by ELSO, and is subject to change without notice. ELSO and its authorized agents and contractors make no representations or warranties about the quality, content, completeness, suitability, adequacy, sequence, accuracy, or timeliness of such content. ELSO disclaims any responsibility for any inaccuracy, whether by inclusion or omission, on the Dashboard or the Site, and disclaims any responsibility for subsequent change or withdrawal of data shown on the Dashboard or the Site, which is subject to alteration without notice. ELSO disclaims any and all warranties regarding this information and all liability whatsoever relating thereto. Any person who uses information obtained from this Dashboard does so at his or her own risk.

The Dashboard is provided as a public service to facilitate real-time sharing of information during the COVID-19 crisis for educational purposes only by health practitioners. ELSO owns the compilation of all data, and its use or publication by any third party is strictly forbidden. Publication or representation of this information as if it were statistically significant or part of a scientific study is irresponsible and misleading.

The tables are consistent with the Lancet Publication article but the data presented here is real time

Barbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E, Bartlett RH, Tonna JE, Hyslop R, Fanning JJ, Rycus PT, Hyer SJ, Anders MM, Agerstrand CL, Hryniewicz K, Diaz R, Lorusso R, Combes A, Brodie D, the Extracorporeal Life Support Organization. Extracorporeal Membrane Oxygenation Support in COVID-19: The Registry Report from the Extracorporeal Life Support Organization. Lancet. 2020; [In Press].

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