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EVOLVING OUTCOMES OF ECMO SUPPORT IN COVID-19 PATIENTS: FINDINGS FROM THE INTERNATIONAL ELSO REGISTRY

ELSO registry data published in The Lancet shows ECMO-supported patients with COVID-19 experienced worsening 90 day in-hospital mortality during 2020; experienced centers had better outcomes

ANN ARBOR, MI – Sept. 29, 2021 – The Extracorporeal Life Support Organization (ELSO) announced today publication in The Lancet of a follow-up to an earlier Lancet publication examining the treatment of COVID-19 patients with extracorporeal membrane oxygenation (ECMO) support. COVID-19 patients treated with ECMO more recently had worse mortality and required support for longer.


The Lancet study is based on the international ELSO registry and reported on 4,812 ECMO patients in 349 centres from 41 countries in 2020. The study found that patients treated at the same collection of centers later in the pandemic had a 15% increase in in-hospital mortality 90-days after ECMO initiation and and the median duration of ECMO support increased by 6 days.


Compared to patients with COVID-19 who received ECMO earlier in the pandemic, more recently a higher proportion of patients received treatment with corticosteroids. Factors appearing to affect outcomes included that more recent ECMO-supported patients had a higher likelihood of treatment-refractory disease despite similar conventional risk factors and that centers with less experience providing ECMO support for COVID-19 were more likely to have a higher mortality rate.


“These data suggest two key issues. First, continued surveillance of local and regional outcomes among ECMO-supported patients with COVID-19 is essential because outcomes can be different from center to center and change overtime. Second, centers should be aware that patients with COVID-19 often required ECMO support for more than a month and we recommend centers establish local polices to guide the ethical allocation of ECMO if it becomes a scarce resource.” said Ryan Barbaro, MD, Chair of ELSO’s Registry Committee and lead author of the study.


Dan Brodie, MD, President-Elect of ELSO and a senior author of the study shares: “These findings suggest that we must continue to be both vigilant and humble about the evolving outcomes of ECMO-supported patients with COVID-19. Ultimately, working collaboratively across centers and gaining further global experience treating these patients should improve outcomes.”


These findings inform the role of ECMO in COVID-19 for patients, clinicians, and policymakers.


About ELSO

The Extracorporeal Life Support Organization (ELSO) is an international non-profit organization comprised of health care institutions and individuals dedicated to the development and evaluation of novel therapies for the support of failing organ systems. The organization’s mission is to provide continuing education, guideline development, original research, publications, and maintenance of a comprehensive registry of data around use of extracorporeal membrane oxygenation (ECMO) in active ELSO centers. Learn more at www.elso.org.


The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01960-7/fulltext