Extracorporeal Life Support Organization
Overview
Guidelines for ECMO in COVID-19
Guidance Document
Reporting COVID-19 Cases
into the ELSO Registry
ECMO Related COVID-19 Research
Messages from ELSO’s President on COVID-19
General Information
on the COVID-19 Pandemic
Online Dashboards
for Tracking Worldwide COVID-19
Webinars & Podcasts
Caregiver Resources
Select Scientific Literature Regarding
ECMO Use for COVID-19
COVID-19 Resource Centers,
Scientific Journal Sites
FDA Approves ECMO Use for
Equipment During Pandemic
Perfusion Task Force
Industry Partners
News Media
ECMO in COVID-19 infection

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/Citation/onlinefirst/Initial_ELSO_Guidance_Document__ECMO_for_COVID_19.98541.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 confirmed by testing 

  • COVID-19 suspected but NO testing 

  • No clinical suspicion of COVID-19 (and no testing) 

  • COVID-19 confirmed negative 

COVID-19 Cases on ECMO in the ELSO Registry:

COVID-19
Suspected or Confirmed
1852
COVID-19
Confirmed Cases
1838
COVID-19
Discharged Alive
692/1236 (55%)
Total counts of COVID-19 confirmed patients and count of COVID-19 suspected but not confirmed by testing.
COVID-19 ECMO counts by ELSO Chapter
North America1136
Europe510
Asia Pacific40
Latin America72
SWAAC94
* not reporting cases where n < 5
Reports counts of ECMO-supported suspected or confirmed COVID-19 cases by ELSO Chapter (provided the chapter has at least 5 cases reported)
FULL COVID-19 REGISTRY DASHBOARD

Disclaimer

 

ECMO Related COVID-19 Research

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. 

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

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

General information regarding
the COVID-19 pandemic can be found at

WHOUnited States Centers for Disease Control and Prevention

Online dashboards
for tracking worldwide COVID-19:

Online dashboards
for tracking worldwide COVID-19:

WHOJohns HopkinsWorldometer COVID-19 Data

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

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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Blood transfusion strategies and ECMO during the COVID-19 pandemic - Authors' reply.
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COVID-19 Respiratory Failure: Targeting Inflammation on VV-ECMO Support.
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https://www.thoracic.org/professionals/clinical-resources/disease-related-resources/covid-19-guidance.pdf

https://jamanetwork.com/journals/jama/fullarticle/2766774?resultClick=1

https://pubmed.ncbi.nlm.nih.gov/32164431/?from_term=Tongers&from_sort=date&from_pos=1

Extracorporeal membrane oxygenation for respiratory failure in COVID-19 patients: outcome and time-course of clinical and biological parameters.
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Abou-Arab O, Mahjoub Y.Huette P, et al.Can J Anaesth.
2020 Jun 1. doi: 10.1007/s12630-020-01727-z Online ahead of print.Can J Anaesth. 2020.
PMID: 32483742

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The COVID-19 pand-ECMO-ic.
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Haye G, Fourdrain A, Abou-Arab O, Berna P, Mahjoub Y.Haye G, et al.
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Osho AA, Moonsamy P, Hibbert KA, Shelton KT, Trahanas JM, Attia RQ, Bloom JP, Onwugbufor MT, D'Alessandro DA, Villavicencio MA,
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2020 May 25. doi: 10.1097/SLA.0000000000004084. Online ahead of print.Ann Surg. 2020.
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SARS-CoV-2/COVID-19: Evidence-Based Recommendations on Diagnosis and Therapy.
Bein B, Bachmann M, Huggett S, Wegermann P.Bein B, et al.Geburtshilfe Frauenheilkd.
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Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic.
Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, Auriau J, Grimaud M, Oualha M, Beghetti M, Wacker J, Ovaert C, Hascoet S, Selegny M, Malekzadeh-Milani S, Maltret A, Bosser G,
Giroux N, Bonnemains L, Bordet J, Di Filippo S, Mauran P, Falcon-Eicher S, Thambo JB, Lefort B, Moceri P, Houyel L, Renolleau S, Bonnet D.Belhadjer Z, et al.Circulation.
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PMID: 32418446

Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship.
Kato H, Shimizu H, Shibue Y, Hosoda T, Iwabuchi K, Nagamine K, Saito H, Sawada R, Oishi T, Tsukiji J, Fujita H, Furuya R, Masuda M,
Akasaka O, Ikeda Y, Sakamoto M, Sakai K, Uchiyama M, Watanabe H, Yamaguchi N, Higa R, Sasaki A, Tanaka K, Toyoda Y, Hamanaka S,
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J Infect Chemother. 2020 May 13. doi: 10.1016/j.jiac.2020.05.005. Online ahead of print.J Infect Chemother. 2020.
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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

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

News Media

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

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.