What is the role of extracorporeal membrane oxygenation (ECMO) in the treatment of coronavirus disease 2019 (COVID-19)?

Updated: Jan 12, 2021
  • Author: Setu K Patolia, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Extracorporeal membrane oxygenation (ECMO) can be used in patients with severe ARDS. To date, the largest series of 1035 patients from the Extracorporeal Life Support Organization (ELSO) registry has shown that patients undergoing ECMO support had an in-hospital 90-day mortality rate of 37.4% (95% confidence interval, 34.4-40.4%). [26] ELSO guidelines recommend to maximize conventional ARDS therapy such as prone positioning, neuromuscular blockade, and appropriate positive end-expiratory pressure therapy prior to initiating ECMO therapy. ECMO is indicated for patients with PaO2/FiO2 ratio of less than 60 mm Hg for more than 6 hours or less than 50 mm Hg for more than 3 hours. ECMO support should be instituted within 7 days of severe ARDS. [27]


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