ECMO in COVID-19
Overview
ELSO is providing this website as a resource for centers who may be called on to manage COVID-19 patients. As this is an emerging infectious disease, the scientific data is constantly evolving. The contents of this page will change rapidly as new information develops. For real time updates, please follow ELSO’s social media accounts at Twitter (@ELSOOrg and @ECMOed) and Facebook (https://www.facebook.com/ELSO.Org) as well as the ECMOed COVID-19 page (https://elso.blog/category/2019ncov-2/)
Guidelines for ECMO in COVID-19
NIH released guidelines for treating COVID-19 patients, acknowledging ECMO as a treatment option in the critical care section. https://www.covid19treatmentguidelines.nih.gov/introduction/
ELSO has prepared an in-depth set of guidelines for ECMO in COVID-19 patients. These have been collaboratively developed by a global team of ECMO experts. The guidelines include: patient selection criteria, cannulation and decannulation strategies, transport on ECMO, PPE and staff protection strategies with ECMO, to ethical dilemmas and quality.
Guidance Document
Initial ELSO Guidance Document – published in the ASAIO Journal:
https://journals.lww.com/asaiojournal/Fulltext/2020/05000/Initial_ELSO_Guidance_Document__ECMO_for_COVID_19.3.aspx
We are pleased to release ELSO`s Guidance on ECMO in COVID-19. This document has been approved by the Executive Committee and Chapter Chairs. It will be updated as necessary.
Reporting COVID-19 Cases into the ELSO Registry
Reporting COVID-19 Cases into the ELSO Registry
Confirmed COVID-19 cases should utilize the ICD-10 emergency code U07.1, 2019-nCoV acute respiratory disease as the primary diagnosis. In an effort to better understand the impact of COVID-19 on ECMO we have also added a question asking if a patient has COVID-19.
There are 4 response options:
COVID-19 Cases on ECMO in the ELSO Registry:
COVID-19
Suspected or Confirmed
2613 |
COVID-19
Confirmed Cases
2604 |
COVID-19
Discharged Alive
1048/1963 (53%) |
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Total counts of COVID-19 confirmed patients and count of COVID-19 suspected but not confirmed by testing.
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| COVID-19 ECMO counts by ELSO Chapter |
| North America | 1689 |
| Europe | 579 |
| Asia Pacific | 51 |
| Latin America | 123 |
| SWAAC | 171 |
| * not reporting cases where n < 5 |
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Reports counts of ECMO-supported suspected or confirmed COVID-19 cases by ELSO Chapter (provided the chapter has at least 5 cases reported)
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FULL COVID-19 REGISTRY DASHBOARD
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Disclaimer
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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.
COVID-19 Critical Care Consortium
ExtraCorporeal Membrane Oxygenation for 2019 novel Coronavirus Acute Respiratory Disease (COVID-19 Critical Care Consortium) is a prospective/retrospective multi-center short period incidence observational study of intensive care unit patients with COVID-19.
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Euro-ELSO
EuroELSO has established a COVID-19 survey and has released results. This is an ongoing effort in the region and we will continue to update this section as more results become available.
Euro-ELSO Survey
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| COVID-19 Critical Care Consortium |
Messages from ELSO’s President on COVID-19
An Update on ECMO in COVID19 from ELSO’s President, Dr. Mark Ogino.Posted May 4, 2020.
ELSO's response to COVID-19 from ELSO's President, Dr. Mark Ogino. The use of ECMO in treating COVID-19 patients.Posted March 14, 2020.
General information regarding
the COVID-19 pandemic can be found at
Webinars & Podcasts
Webinar:
Critical care & ECMO in the era of COVID-19: why data matters
On Jun 08, 2020 ELSO hosted a webinar: 'Critical care & ECMO in the era of COVID-19: why data matters'. Critical care & ECMO in the era of COVID-19: why data matters! ELSO webinar, moderated by Dr. Robert Bartlett & Matt Paden, highlighting the current research underway focused on better understanding the impact of COVID-19, and the role of extracorporeal support and ICU care in patients with SARS-CoV-2 Coronavirus infection. Topics & speakers:
ELSO Registry and the live dashboard for COVID-19 Cases: Matt Paden & Ryan Barbaro
EuroELSO Survey on ECLS in COVID-19, Roberto Lorusso & Jan Bělohlávek
COVID-Critical Care Consortium, John Fraser & Heidi Dalton
On April 22, 2020 ELSO hosted a webinar ‘ECMO COVID-19 What we have learned.’ Speakers & topics: Christian Bermudez - ECMO Center Organization and Regional Coordination; Holt Murray - Regional ECMO Coordination; 10 years in 10 minutes Erik Osborn - COVID-19 & ECMO Experiences & Management; Tim Maul - Inflammation & Coagulation for SARS-CoV-2 a Perfusionist’s Perspective; Troy Seelhammer - ECMO in COVID-19: Is There a Role for Bivalirudin? All slides available at https://bit.ly/2RZpAHc
Watch the STS Webinar from Thursday, April 23rd - Webinar on COVID Crisis
Cardiothoracic surgeons around the globe quickly adapted to the challenges presented by the COVID pandemic. Among the issues has been an increased need for extracorporeal membrane oxygenation (ECMO), without the required resources to meet the demand.
Explain the role of the Extracorporeal Life Support Organization (ELSO) in guiding physicians and other practitioners through preparations for the COVID pandemic.
On Friday, April 3rd, 2020 at 4:00pm Eastern ELSO hosted a webinar: The Power of Connection. In that webinar, we discussed the power of sharing information in real-time using WhatsApp COVID19 chat rooms so that we can share what we are learning about COVID-19 patients on ECMO quickly (Tammy Friedrich, Holli Williams, Amy Hackman). We also shared the experiences with COVID-19 patients on ECMO in Seattle (Jenelle Badulak), NYC (Cara Agerstrand), and Paris (Matthieu Schmidt). You can view the webinar anytime above.
Preparing to support #COVID19 patients on #ECMO: first ELSO webinar dedicated to the role of extracorporeal support in patients with #SARSCoV2 infection, speakers:
Dr. Ram Ramanathan
Dr. Kiran Shekar
Dr. Michael Matthay
COVID-19 Experience in Italy
Listen to Italian COVID19 experience from Pediatrica intensiva on Apple Podcasts.
https://podcasts.apple.com/us/podcast/pediatrica-intensiva/id1502496721?i=1000468384785
Caregiver Resources
https://www.cstsonline.org/assets/media/documents/CSTS_FS_Sustaining_Well_Being_Healthcare_Personnel_during.pdf
Select Scientific Literature regarding ECMO Use for COVID-19:
ECMO Related
Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) - https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf Published February 29, 2020.
Editor note: Comprehensive summary of the China response. Comments regarding ECMO use in the paper: “The application of intubation/invasive ventilation and ECMO in critically ill patients can improve survival. The Joint Mission Team was told of ECMO use in four patients at one hospital with one death and three who appeared to be improving. Clearly, though ECMO is very resource consumptive, any health system would need to carefully weigh the benefits.”
Min L, Gu S, Wu X, et al. Extracorporeal membrane oxygenation support in 2019 novel coronavirus disease: indications, timing, and implementation. Chinese Medical Journal. Published February 28, 2020. doi: 10.1097/CM9.0000000000000778.
Editor note: A guide with review of previous literature of ECMO patients, and clinical/technical points on cannulating while keeping staff safe. No patient level data.
Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respiratory Medicine. Published February 24, 2020. doi: 10.1016/S2213-2600(20)30079-5. December-January Wuhan report. Editor note: Six ECMO patients – 1/6 survival.
MacLaren G, Fisher D, Brodie D. Preparing for the Most Critically Ill Patients With COVID-19The Potential Role of Extracorporeal Membrane Oxygenation. JAMA. Published online February 19, 2020. doi: 10.1001/jama.2020.2342
Editor note: Viewpoint in JAMA from ELSO leaders about the use of ECMO during the pandemic. “ECMO is not a therapy to be rushed to the frontline when all resources are stretched in a pandemic.”
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Published Feburary 7, 2020. JAMA 2020. doi: 10.1001/jama.2020.1585. Editor note: Follow-up report of 138 patients from Wuhan. Four ECMO patients, no outcomes described.
Ronco C, Navalesi P, Vincent JL. Coronavirus epidemic: preparing for extracorporeal organ support in intensive care. Lancet Respiratory Medicine. Published February 6, 2020. doi: 10.1016/S2213-2600(20)30060-6
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-513. doi: 10.1016/S0140-6736(20)30211-7. Follow-up report of 99 patients from Wuhan. Editor note: Three ECMO patients, one described and died, no report on outcome of the other two.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.doi: 10.1016/S0140-6736(20)30183-5
Editor note: Initial report of 41 total patients from Wuhan. Two ECMO patients, no survival data given.
Kollengode Ramanathan MD, David Antognini MBBS, Alain Combes MD, Matthew Paden MD, Bishoy Zakhary MD, Mark Ogino MD, Graeme MacLaren MS, Daniel Brodie MD, Kiran Shekar PhD. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases, March 20, The Lancet. doi: 10.1016/S2213-2600(20)30121-1
Clinical Management
Murthy S, Gomersall CD, Fowler RA. Care for Critically Ill Patients With COVID-19. JAMA. Published online March 11, 2020. doi: 10.1001/jama.2020.3633
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. Published March 11, 2020. doi: 10.1016/S0140-6736(20)30566-3
Namendys-Silva SA. Respiratory support for patients with COVID-19 infection. Lancet Respiratory Medicine. Published March 05, 2020. doi: 10.1016/S2213-2600(20)30110-7
DelRio C, Nalani PN. COVID-19—New Insights on a Rapidly Changing Epidemic. JAMA. Published online February 28, 2020. doi: 10.1001/jama.2020.3072
Team Related
Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic JAMA. Published online March 12, 2020. doi: 10.1001/jama.2020.3972.
Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. Published February 26, 2020. doi: 10.1016/S0140-6736(20)30460-8
Epidemiology
Ghinai I, McPherson TD, Hunter JC, et al. First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA. Lancet. Published March 13, 2020. doi: 10.1016/S0140-6736(20)30607-3
Chinazzi M, Davis JT, Ajelli M, et al. The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science. Published March 6, 2020. doi: 10.1126/science.aba9757
Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. Published March 5, 2020. N Engl J Med 2020; 382:929-936. doi: 10.1056/NEJMoa2001191
Guan Ej, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. Published February 28, 2020. doi: 10.1056/NEJMoa2002032
Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. Published January 29, 2020. doi: 10.1056/NEJMoa2001316
Ramanathan K, Antognini D, Combes a, Paden M, Zakhary B, Ogino M. et al. Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. The Lancet. 2020 (Published online March 20). DOI: https://doi.org/10.1016/S2213-2600(20)30121-1
Henry M. COVID-19, ECMO and lymphopenia: a word of caution. The Lancet - Published Online March 13, 2020 https://doi.org/10.1016/ S2213-2600(20)30119-3
Observational concerns exist regarding the potential harm in use of ECMO for COVID-19. The Yang et al study describes the use of Extracorporeal Membrane Oxygenation (ECMO) in a small cohort of patients with an 83% mortality (5/6 patients).
Previously described data has shown an increased severity of disease in COVID-19 regarding lymphocyte count.
Lymphocyte counts are significantly lower in non-survivors. ECMO patients have shown substantial decreases in number and function of lymphocytes. Interleukin-6 (IL-6) in non-survivors is 1•7-times higher in COVID -19 patients. Survivors had normalized values. Consideration should be to track lymphocyte counts as well as IL-6 during ECMO to help identify patient prognosis.
Zhonghua Jie He He Hu Xi Za Zhi = Zhonghua Jiehe He Huxi Zazhi, Chinese Society of Extracorporeal Life Support. "[Recommendations on Extracorporeal Life Support for Critically Ill Patients With Novel Coronavirus Pneumonia]." = Chinese Journal of Tuberculosis and Respiratory Diseases, vol. 43, no. 3, March 12, 2020, pp. 195-198. https://www.ncbi.nlm.nih.gov/pubmed/32164087
Giani M, Seminati D, Lucchini A, Foti G, Pagni F, Exuberant plasmacytosis in bronchoalveolar lavage of the first patient requiring Extracorporeal Membrane Oxygenation for SARSCoV-2 in Europe, Journal of Thoracic Oncology (March 4, 2020), doi: https://doi.org/10.1016/j.jtho.2020.03.008
PubMed Results
Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure
Nationwide system to centralize decisions around ECMO use for severe COVID-19 pneumonia in Japan (Special Correspondence).
Japan ECMsOnet for COVID-19.
J Intensive Care. 2020 Apr 24;8:29. doi: 10.1186/s40560-020-00445-4. eCollection 2020.
PMID: 32341785 [PubMed]
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PMID: 32405245
Successful COVID-19 rescue therapy by extra-corporeal membrane oxygenation (ECMO) for respiratory failure: a case report.
Firstenberg MS, Stahel PF, Hanna J, Kotaru C, Crossno J Jr, Forrester J.Firstenberg MS, et al.Version 2. Patient Saf Surg.
2020 May 8;14:20. doi: 10.1186/s13037-020-00245-7. eCollection 2020.Patient Saf Surg. 2020.
PMID: 32395179
COVID-19 and ECMO: the interplay between coagulation and inflammation-a narrative review.
Kowalewski M, Fina D, Słomka A, Raffa GM, Martucci G, Lo Coco V, De Piero ME, Ranucci M, Suwalski P, Lorusso R.Kowalewski M, et al.Version 2. Crit Care.
2020 May 8;24(1):205. doi: 10.1186/s13054-020-02925-3.Crit Care. 2020.
PMID: 32384917
Extracorporeal oxygenation and COVID-19 epidemic: is the membrane fail-safe to cross contamination?
Squiccimarro E, Rociola R, Haumann RG, Grasso S, Lorusso R, Paparella D.Squiccimarro E, et al.
ASAIO J. 2020 May 7. doi: 10.1097/MAT.0000000000001199. Online ahead of print.ASAIO J. 2020.
PMID: 32384284
Utility of extracorporeal membrane oxygenation in COVID-19.
Khan R, Anandamurthy B, McCurry K, Krishnan S.Khan R, et al.Cleve Clin J Med.
2020 May 5. doi: 10.3949/ccjm.87a.ccc014. Online ahead of print.Cleve Clin J Med. 2020.
PMID: 32371555
Extracorporeal Life Support Organization COVID-19 Interim Guidelines.
Shekar K, Badulak J, Peek G, Boeken U, Dalton HJ, Arora L, Zakhary B, Ramanathan K, Starr J, Akkanti B, Antonini MV, Ogino MT, Raman L; ELSO Guideline Working Group*.Shekar K, et al.
ASAIO J. 2020 Apr 29:10.1097/MAT.0000000000001193. doi: 10.1097/MAT.0000000000001193. Online ahead of print.ASAIO J. 2020.
PMID: 32358233
Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO-A "Living Working Document".
Rajagopal K, Keller SP, Akkanti B, Bime C, Loyalka P, Cheema FH, Zwischenberger JB, El Banayosy A, Pappalardo F, Slaughter MS, Slepian MJ.Rajagopal K, et al.
ASAIO J. 2020 Jun;66(6):588-598. doi: 10.1097/MAT.0000000000001180.ASAIO J. 2020.
PMID: 32358232
Nationwide system to centralize decisions around ECMO use for severe COVID-19 pneumonia in Japan (Special Correspondence).
Japan ECMsOnet for COVID-19.Japan ECMsOnet for COVID-19.Version 2. J Intensive Care.
2020 Apr 24;8:29. doi: 10.1186/s40560-020-00445-4. eCollection 2020.J Intensive Care. 2020.
PMID: 32341785
Towards precision delivery of ECMO in COVID-19 cardiorespiratory failure.
Zochios V, Brodie D, Parhar KK.Zochios V, et al.
ASAIO J. 2020 Apr 23:10.1097/MAT.0000000000001191.doi: 10.1097/MAT.0000000000001191. Online ahead of print.ASAIO J.2020.
PMID: 32341294
Regional Planning for Extracorporeal Membrane Oxygenation Allocation During Coronavirus Disease 2019.
Prekker ME, Brunsvold ME, Bohman JK, Fischer G, Gram KL, Litell JM, Saavedra-Romero R, Hick JL.Prekker ME, et al.
Chest. 2020 Apr 25:S0012-3692(20)30769-8. doi: 10.1016/j.chest.2020.04.026. Online ahead of print.Chest. 2020.
PMID: 32339510
Delivering extracorporeal membrane oxygenation for patients with COVID-19: what, who, when and how?
Zochios V, Brodie D, Charlesworth M, Parhar KK.Zochios V, et al.Anaesthesia.
2020 Apr 22. doi: 10.1111/anae.15099. Online ahead of print.Anaesthesia. 2020.
PMID: 32319081
Blood transfusion strategies and ECMO during the COVID-19 pandemic.
Koeckerling D, Pan D, Mudalige NL, Oyefeso O, Barker J.Koeckerling D, et al.Lancet Respir Med.
2020 May;8(5):e40. doi: 10.1016/S2213-2600(20)30173-9. Epub 2020 Apr 16.Lancet Respir Med. 2020.
PMID: 32305078
Blood transfusion strategies and ECMO during the COVID-19 pandemic - Authors' reply.
Ramanathan K, MacLaren G, Combes A, Brodie D, Shekar K.Ramanathan K, et al.Lancet Respir Med.
2020 May;8(5):e41. doi: 10.1016/S2213-2600(20)30174-0. Epub 2020 Apr 16.Lancet Respir Med. 2020.
PMID: 32305077
Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers.
Shekar K, Badulak J, Peek G, Boeken U, Dalton HJ, Arora L, Zakhary B, Ramanathan K, Starr J, Akkanti B, Antonini MV,
Ogino MT, Raman L, Barret N, Brodie D, Combes A, Lorusso R, MacLaren G, Müller T, Paden M, Pellegrino V; ELSO
Guideline Working Group.
ASAIO J. 2020 Jul;66(7):707-721. doi: 10.1097/MAT.0000000000001193.
PMID: 32604322
Veno-venous Extracorporeal Membrane Oxygenation Support in COVID-19 Respiratory Distress Syndrome: Initial Experience.
Loforte A, Dal Checco E, Gliozzi G, Benedetto M, Cavalli GG, Mariani C, Piccone G, Agulli M, Pacini D, Baiocchi M.
ASAIO J. 2020 Jul;66(7):734-738. doi: 10.1097/MAT.0000000000001198.
PMID: 32597627
COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.
Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M, Lancella L, Calò Carducci FI, Gabrovska N, Velizarova S,
Prunk P, Osterman V, Krivec U, Lo Vecchio A, Shingadia D, Soriano-Arandes A, Melendo S, Lanari M, Pierantoni L,
Wagner N, L'Huillier AG, Heininger U, Ritz N, Bandi S, Krajcar N, Roglić S, Santos M, Christiaens C, Creuven M,
Buonsenso D, Welch SB, Bogyi M, Brinkmann F, Tebruegge M; ptbnet COVID-19 Study Group.
Lancet Child Adolesc Health. 2020 Jun 25:S2352-4642(20)30177-2. doi: 10.1016/S2352-4642(20)30177-2. Online ahead of print.
PMID: 32593339
Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection: A Multi-institutional Study from New York City.
Kaushik S, Aydin SI, Derespina KR, Bansal PB, Kowalsky S, Trachtman R, Gillen JK, Perez MM, Soshnick SH, Conway EE
Jr, Bercow A, Seiden HS, Pass RH, Ushay HM, Ofori-Amanfo G, Medar SS.
J Pediatr. 2020 Jun 14:S0022-3476(20)30747-2. doi: 10.1016/j.jpeds.2020.06.045. Online ahead of print.
PMID: 32553861
Bedside veno-venous ECMO cannulation: A pertinent strategy during the COVID-19 pandemic.
Calcaterra D, Heather B, Kohl LP, Erickson HL, Prekker ME.
J Card Surg. 2020 Jun;35(6):1180-1185. doi: 10.1111/jocs.14641.
PMID: 32531129
ECMO use in COVID-19: lessons from past respiratory virus outbreaks-a narrative review.
Cho HJ, Heinsar S, Jeong IS, Shekar K, Li Bassi G, Jung JS, Suen JY, Fraser JF.
Version 2. Crit Care. 2020 Jun 6;24(1):301. doi: 10.1186/s13054-020-02979-3.
PMID: 32505217
Thrombotic circuit complications during venovenous extracorporeal membrane oxygenation in COVID-19.
Bemtgen X, Zotzmann V, Benk C, Rilinger J, Steiner K, Asmussen A, Bode C, Wengenmayer T, Maier S, Staudacher DL.
J Thromb Thrombolysis. 2020 Jul 11. doi: 10.1007/s11239-020-02217-1. Online ahead of print.
PMID: 32653986
Clinical Characteristics and Outcomes of 74 Patients With Severe or Critical COVID-19.
Li J, Xu G, Yu H, Peng X, Luo Y, Cao C.
Am J Med Sci. 2020 Jun 1:S0002-9629(20)30232-9. doi: 10.1016/j.amjms.2020.05.040. Online ahead of print.
PMID: 32653160
COVID-19 PICU guidelines: for high- and limited-resource settings.
Kache S, Chisti MJ, Gumbo F, Mupere E, Zhi X, Nallasamy K, Nakagawa S, Lee JH, Di Nardo M, de la Oliva P, Katyal C,
Anand KJS, de Souza DC, Lanziotti VS, Carcillo J.
Pediatr Res. 2020 Jul 7. doi: 10.1038/s41390-020-1053-9. Online ahead of print.
PMID: 32634818
Recommendations for extracorporeal membrane oxygenation (ECMO) in COVID-19 patients : Consensus paper of the Medical University of Vienna.
Wiedemann D, Bernardi MH, Distelmaier K, Goliasch G, Hengstenberg C, Hermann A, Holzer M, Hoetzenecker K,
Klepetko W, Lang G, Lassnigg A, Laufer G, Magnet IAM, Markstaller K, Röggla M, Rössler B, Schellongowski P, Simon P,
Tschernko E, Ullrich R, Zimpfer D, Staudinger T; COVID-19 ECMO Research Group Medical University of Vienna.
Wien Klin Wochenschr. 2020 Jul 3:1-6. doi: 10.1007/s00508-020-01708-8. Online ahead of print.
PMID: 32621065
Successful recovery from critical COVID-19 pneumonia with extracorporeal membrane oxygenation: A case report.
Ikuyama Y, Wada Y, Tateishi K, Kitaguchi Y, Yasuo M, Ushiki A, Urushihata K, Yamamoto H, Kamijo H, Mita A, Imamura
H, Hanaoka M.
Version 2. Respir Med Case Rep. 2020 May 31;30:101113. doi: 10.1016/j.rmcr.2020.101113. eCollection 2020.
PMID: 32523870
COVID-19 Resource Centers, Scientific Journal Sites
The New England Journal of Medicine: https://www.nejm.org/coronavirus
Journal of American Medical Association: https://jamanetwork.com/journals/jama/pages/coronavirus-alert
Science: https://www.sciencemag.org/coronavirus-research-commentary-and-news?IntCmp=coronavirussiderail-128
The Lancet: https://www.thelancet.com/coronavirus?dgcid=kr_pop-up_tlcoronavirus20
Under COVID-19 Global Dashboard: https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
FDA Approves ECMO Use for Equipment During Pandemic
FDA released guidance for industry and FDA staff on Enforcement Policy for Extracorporeal Membrane Oxygenation and Cardiopulmonary Bypass Devices During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency.
https://www.fda.gov/media/136734/download
Perfusion Task Force
The Joint Perfusion COVID-19 Task Force was assembled recently with the main perfusion professional societies (AmSECT, AACP, ABCP) and additional partners. We are proud to collaborate with all partners working toward the common goal of improving COVID-19 patient outcomes. Please join, if interested, which is free:
https://www.jointperfusiontaskforce.org/
Industry Partners:
Please find the guidance from our industry partners on COVID-19 and ECMO equipment, such as what is currently known about COVID-19 in oxygenators.
Use_of_Getinge_oxygenators_in_Covid19_Internationl Letter.pdf
Getinge_COVID-19_MCP products_US Final_04042020.pdf
Xenios AG Extra Corporeal Life Support (ECLS) products in critically ill patients suffering from COVID-19
https://www.nytimes.com/2020/04/26/health/coronavirus-patient-ventilator.html?action=click&module=Spotlight&pgtype=Homepage
News article on treating COVID-19 patients with ECMO, referencing Michigan Medicine, Dr. Bartlett, and current ECMO Director Jonathan Haft: https://www.wxyz.com/news/coronavirus/rare-life-support-system-pioneered-by-u-of-m-doctor-helps-covid-19-patients
Use of ECMO in COVID-19 patients, ELSO, and history of ECMO: https://labblog.uofmhealth.org/rounds/when-ventilators-dont-help-covid-19-patients-might
https://www.wxyz.com/news/coronavirus/rare-life-support-system-pioneered-by-u-of-m-doctor-helps-covid-19-patients
In Critical Coronavirus Cases, Doctors Turn to Last-Ditch Lung Support – WSJ
https://www.washingtonpost.com/outlook/2020/04/14/coronavirus-heart-lung-bypass/
https://www.nbcnews.com/news/us-news/46-year-old-doctor-coronavirus-was-critically-ill-made-startling-n1208641
A ventilator wasn't enough to treat him for Covid-19. This machine became his last chance for survival
Doctors in Arizona doubted that Dr. Karl Viddal was going to make it. The ventilator was running at its highest setting and still wasn't enough for his lungs.
Read in CNN: https://apple.news/AVyULfn_1ST-KmMYXmRG2vA
https://www.thestar.com/news/gta/2020/06/14/covid-19-was-killing-him-how-a-last-resort-intervention-brought-this-toronto-man-back-from-the-brink.html
“Father of ECMO: When a Ventilator Isn’t Enough”:
https://www.medscape.com/viewarticle/934404?nlid=136562_530&src=WNL_mdplsfeat_200728_mscpedit_ccmd&uac=261132HN&spon=32&impID=2480721&faf=1#vp_1
Inside the Fight to Save Houston’s Most Vulnerable https://www.nytimes.com/interactive/2020/08/10/us/houston-hospital-coronavirus.html?referringSource=articleShare
Extracorporeal organs could save the sickest patients from Covid-19 https://www.medicaldevice-network.com/features/ecmo-covid-19-2/
ECMO in COVID-19 infection
The WHO is distributing an Interim Guidance document for the
"Clinical management of severe acute respiratory infection when Novel coronavirus (nCoV) infection is suspected. (https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected)" The WHO guidance document includes a statement to "consider referral patients with refractory hypoxemia despite lung-protective ventilation in settings with access to expertise in ECLS." Similarly, the United States Center for Disease Control provides interim guidance (https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html) for clinical management of COVID-19 patients with and without acute respiratory distress syndrome (ARDS). Where ECLS expertise is available, ECLS should be considered according to the standard management algorithm for ARDS in supporting patients with viral lower respiratory tract infection. However, clearly, at this time, there is little worldwide experience with using ECLS to support COVID-19 patients. ELSO leaders have discussed the potential role of ECMO for COVID-19 patients in a recent Journal of the American Medical Association Viewpoint (https://jamanetwork.com/journals/jama/articlepdf/2761778/jama_maclaren_2020_vp_200024.pdf). ELSO will continue to collect data through our member centers through the ELSO Registry and provide recommendations as additional information becomes available.