Table 5.
ECMO use and outcomes
| Variable | ECMO group (n = 92) |
|---|---|
| Duration of ECMO use, days | 15.4 ± 10.1 (1–52) |
| Indication for ECMO insertion | |
| COVID-19-related ARDS | 88 (95.6%) |
| Other | 4 (4.3%) |
| Cannulation procedure | |
| Percutaneous | 85 (92.4%) |
| Cutdown | 2 (2.2%) |
| ECMO insertion location | |
| Same center the patient is in now | 45 (48.9%) |
| Another hospital then transported to this center | 45 (48.9%) |
| Type of transportation | |
| Ground transport | 38 (41.3%) |
| Air medical transport | 7 (7.6%) |
| Distance from the referring facility to the receiving hospital, kilometers | 155.9 ± 279.2 (2–1,045) |
| Duration of transportation, minutes | 4.7 ± 6.5 (0.6–34.8) |
| Initial ECMO mode | |
| VV ECMO | 86 (93.5%) |
| VA ECMO | 3 (3.3%) |
| VAV ECMO | 1 (1.1%) |
| Prone positioning within 24 h of ECMO initiation | 39 (42.4%) |
| Mode of ventilation 2 h pre-ECMO | |
| PC | 14 (0.9%) |
| VC | 23 (1.5%) |
| PRVC | 17 (1.1%) |
| SIMV | 1 (0.1%) |
| HFOV | 1 (0.1%) |
| Other | 3 (0.2%) |
| Mode of ventilation 72 h post-ECMO | |
| PC | 51 (55.4%) |
| VC | 25 (27.2%) |
| PRVC | 8 (8.7%) |
| HFOV | 1 (1.1%) |
| CMV | 1 (1.1%) |
| Prone positioning after 72 h of ECMO initiation | 5 (5.4%) |
| ECMO maximum (highest) blood flow, L/minute | 4.5 ± 0.8 (2–8) |
| ECMO maximum (highest) sweep gas flow, L/minute | 6 ± 1.8 (3–10) |
| Blood transfusion products used while patient was on ECMO | |
| Packed red blood cells | 75 (81.5%) |
| Fresh frozen plasma | 40 (43.5%) |
| Platelets | 33 (35.8%) |
| Cryoprecipitate | 14 (15.2%) |
| Factor VII | 2 (2.2%) |
| Tranexamic acid | 4 (4.3%) |
| ECMO mode conversion data | |
| Patient underwent conversion (change) of ECMO mode | 4 (4.3%) |
| Mode of ECMO was changed (from-to) | |
| VV to VAV | 1 (1.1) |
| VV to VA | 2 (2.2%) |
| VAV to VV | 1 (1.1%) |
| Complications during ECMO | |
| Bleeding from cannulation site | 30 (32.6%) |
| Oxygenator failure requiring circuit change | 8 (8.7%) |
| ECMO circuit clotting | 7 (7.6%) |
| ECMO outcome | |
| Successful decannulation | 42 (45.6%) |
| Withdrawal of ECMO support | 5 (5.4%) |
| Death | 45 (48.9%) |
| Cause of death | |
| Septic shock | 18 (19.6%) |
| Multiple organ failure | 10 (10.9%) |
| Cardiac arrest | 4 (4.3%) |
| Do-not-resuscitate order | 4 (4.3%) |
| Tension pneumothorax | 1 (1.1%) |
| Severe lung fibrosis | 1 (1.1%) |
| Intra-abdominal abscess | 1 (1.1%) |
| Intracerebral hemorrhage | 2 (2.2%) |
| Severe hypotension | 2 (2.2%) |
| Cardiogenic shock | 1 (1.1%) |
| Mixed shock | 1 (1.1%) |
Data are presented as mean ± SD (minimum–maximum), or number (%), unless otherwise indicated
APRV airway pressure release ventilation, ARDS acute respiratory distress syndrome, CMV continuous mandatory ventilation, COVID-19 coronavirus disease 2019, ECMO extracorporeal membrane oxygenation, HFOV high frequency oscillatory ventilation, PC pressure control, PRVC pressure-regulated volume control, PS pressure support, SD standard deviation, SIMV synchronized intermittent mandatory ventilation, VA venoarterial, VAV veno–arterial–venous, VC volume control, VV venovenous
Percentages do not total 100% owing to missing data