Results
During this study period, 20 patients with ARDS positive for COVID-19
underwent ECMO placement. All patients were placed on veno-veno ECMO,
and the mean length of ECMO placement was 14.0 days. The average length
of symptoms prior to ECMO placement was 11.4 days, with the average
patient spending 10.3 days in the hospital prior to ECMO placement. The
average time spent on a ventilator prior to ECMO placement was 147
hours. 75% of patients (n=15) were transferred from another institution
to our hospital, and 60% of patients (n=12) had ECMO initiated at
another institution prior to transfer. Pre-ECMO characteristics and
patient demographics are displayed in Table 2. Patients were also
treated with different therapies prior to starting ECMO placement.
Therapy was administered in the form of steroids (65%, n=13),
interleukin-6 inhibitors (55%, n=11), remdesivir (20%, n=4), and
plasma (15%, n=3). None of the treatment therapies were associated with
better or worse mortality rates. The types of treatment and their
statistics are displayed in Table 3.
The ECMO survival rate was (15/20), and the survival rate to hospital
discharge was 55% (11/20). 11 patients were labeled as Survivors and 9
as Non-Survivors based on their survival to hospital discharge. The only
baseline characteristic that was statistically different between the two
groups was age, as Non-Survivors were significantly older than Survivors
(58.4 vs. 49.6, p=0.02).
The causes of death were septic shock (44%, n=4), culture-negative
systemic inflammatory response syndrome (SIRS) (44%, n=4), and stroke
(11%, n=1). The most common complication observed was renal failure
requiring renal replacement therapy (35%, n=7). Complications that were
associated with patient mortality between the two groups were blood
culture positive sepsis (p=0.01), culture-negative systemic inflammatory
response syndrome (SIRS) (p=0.01), cannula site bleeding (p=0.04), and
renal failure (p=0.01). The complications are displayed in Table 4.