Results
45 patients with ARDS who underwent VV-ECMO placement met our inclusion criteria and were included in this study. Of those patients, 28 had ARDS due to COVID-19 and 17 had ARDS due to influenza. 64% of COVID-19 patients (n=18) and 65% of influenza patients (n=11) were transferred from an outside of hospital to our institution, with a significantly higher percentage of COVID-19 patients having ECMO initiated outside of our hospital (50% vs. 12%, p=0.01). Avalon cannula©was used more often in influenza patients than COVID-19 patients (88% vs. 7%, p<0.01). The average duration of ECMO utilization in COVID-19 patients was 21.4 days, which was significantly longer than the average duration of influenza patients (12.2 days) (p=0.03).
COVID-19 patients had lower incidence of pre-ECMO comorbidities including history of coronary artery disease (p=0.02) and acute kidney injury (p=0.05). They also had a lower body surface area (p=0.04). There were no statistically significant differences in the vital signs before ECMO placement. Patient demographics and pre-ECMO characteristics are displayed in Table 2.
Patients with ARDS due to COVID-19 had a significantly decreased ECMO survival rate (p=0.04). Of the COVID-19 patients, 19 (68%) survived ECMO and 15 (54%) survived to 30 days after decannulation. Among influenza patients, 16 (94%) survived ECMO and 13 (76%) survived to 30 days after decannulation.
The most common complication among COVID-19 patients was the development of a new infection during ECMO, with 14 patients (50%) developing a new infection after the placement of ECMO. Among influenza patients, the most common complications were renal failure, GI bleeds, and new infections, all of which occurred in 3 patients (18%). COVID-19 patients had significantly higher rates of bacterial pneumonia (p=0.03), any new infections (p=0.03), and blood culture-positive sepsis (p=0.04), as displayed in Table 3.