ECMO in COVID-19 patients
The urgent need to treat critically ill patients with an unknown
evolution has forced cardiovascular surgeons to decide whether or not to
implant an ECMO system when the scientific evidence available, in the
context of COVID-19, was sparse and weak. Only a few published cases
from China were available at the beginning of the pandemic (23, 24).
To add some confusion, concerns were raised about the possible
deleterious effect of ECMO in this disease; it is know that during ECMO
support there are substantial decreases in number and function of some
lymphocyte populations, as well as consistently high IL-6 concentrations
inversely correlated with survival. Prudence advised to consider the
immunological status of patients when selecting ECMO candidates and
seriously tracking both lymphocyte count and IL-6 during support.