In patients with acute respiratory distress syndrome (ARDS) due to COVID-19, indications for Extracorporeal Membrane Oxygenation (ECMO) are similar to indications for its use in other clinical scenarios. ECMO may be considered when other advanced treatments fail, such as lung-protective ventilation, prone positioning, and high positive end-expiratory pressure (PEEP).1
For specific patient populations, there is solid clinical evidence to support the utility of ECMO. COVID-19 therapy protocols across the country are increasingly adopting this life-saving treatment.
Case Study: ECMO Treatment for COVID-19
According to a Fresenius Medical Care report, 28-year-old Samantha Oravec suffered from COVID-19 infection during her third trimester of pregnancy. Following a successful C-section to save her baby, Samantha required continued mechanical ventilation. As her respiratory and clinical status declined, Dr. J.W. Awori Hayanga, Director of the ECMO Program at WVU Heart and Vascular Institute, approved Samantha as a candidate for Novalung® ECMO Therapy.2
Comparing ECMO vs. Ventilator for COVID-19
Novalung is an ECMO machine for COVID-19 treatment. Unlike a ventilator, ECMO provides extracorporeal circulation and physiologic gas exchange in cases of severe respiratory or cardiac failure. Novalung has been approved by the FDA for more than six hours of use. This indication makes Novalung an important therapy option for treating patients with severe COVID-19 disease.
How Does ECMO Work?
ECMO provides extended cardiac and respiratory support to patients whose heart and lungs cannot adequately function to sustain life. There are two types of ECMO:
- Venovenous ECMO: Blood is removed from the venous system, passed through an artificial lung, and returned back to the venous system. The oxygenated blood then passes through the lungs.
- Venoarterial ECMO: Blood is removed from the venous system, passed through an artificial lung, and returned to the arterial system. This method provides both cardiac and pulmonary support.
Recovery After ECMO COVID-19 Treatment
Initially, Samantha responded well to Novalung, and she was taken off ECMO for eight days. However, the infection returned, and she required a second round of ECMO. The treatment was successful in helping her to recover and return home.
How Long Can COVID-19 Patients Stay On ECMO?
Weaning patients from ECMO treatment for COVID-19 depends on improvements in lung compliance and arterial oxyhemoglobin saturation. Data indicates that longer durations of ECMO support for COVID-19 patients may be necessary compared to other causes of ARDS. In one study, a median duration of 29 days was required.3 Other studies support the use of ECMO for three to six weeks.4
ECMO for COVID-19 Patients Saves Lives
Samantha’s success story is but one among many cases where ECMO proved to be a valuable treatment for severe COVID-19 infection. According to the Fresenius report, Dr. Hayanga has successfully treated other pregnant women with ECMO. Several clinical studies have established ECMO as a valuable treatment option for COVID-19 patients with acute respiratory or cardiac failure.5
Indications For ECMO Use
ECMO systems, such as Novalung, are indicated for long-term (>6 hours) respiratory and cardiopulmonary support in adults with ARDS.
ECMO is indicated when other treatment options have failed, and continued clinical decline is anticipated or the risk of death is imminent. These clinical indicators may include, but are not limited to:
- Failure to wean from cardiopulmonary bypass following cardiac surgery in adults
- ECMO-assisted cardiopulmonary resuscitation in adults
Click here to learn more about ECMO treatment for acute respiratory failure or acute cardiopulmonary failure.
- Fitzsimons, M. G. (2022, April 27). COVID-19: Extracorporeal membrane oxygenation (ECMO). https://www.uptodate.com/contents/covid-19-extracorporeal-membrane-oxygenation-ecmo.
- ECMO in the time of COVID-19. (2022, January 12). Fresenius Medical Care. https://fmcna.com/insights/articles/ecmo-covid19/
- Mustafa, A. K. (2020, October 1). Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure. https://pubmed.ncbi.nlm.nih.gov/32780089/.
- UpToDate. (n.d.). UpToDate – Evidence-based Clinical Decision Support | Wolters Kluwer. https://www.uptodate.com/contents/covid-19-extracorporeal-membrane-oxygenation-ecmo/abstract/3,5,20
- UpToDate. (n.d.). UpToDate – Evidence-based Clinical Decision Support | Wolters Kluwer.