CHANGING MORTALITY WITH ECLS IN COVID-19: ONE TERTIARY CENTER'S LONGITUDINAL EXPERIENCE

Abstract

TYPE: Abstract TOPIC: Critical Care PURPOSE: The use of ECMO as a rescue therapy in patients with COVID-related severe respiratory and/or cardiac dysfunction has become accepted care in many centers. We reviewed our outcomes in COVID ECMO patients over time. METHODS: IRB-approved database review and analysis of 65 patients in our center who had undergone ECLS related to COVID 19 beginning March 2020 through September 2021. RESULTS: Quarterly data is shown. Survival rates improved from 64% in 2020 to 68% in 2021. Length of ECLS therapy for survivors was shorter with mean duration of support of 11.8 days (range: 3 – 36 days, 2020 mean: 11.3 days, 2021 mean: 13.4 days) compared to the mean duration of support in those who died of 40 days (range: 1 – 164 days, 2020 mean: 36.4 days, 2021 mean: 52.8 days). Median age increased from 46.6 to 49 years between 2020 and 2021. The longest run of 164 days was in a patient who was transitioned to ECCO2R after 120 days. CONCLUSIONS: We found improved survival at our center, as compared to 50% survival reported to the ELSO registry for COVID-19 ECLS. The decrease in COVID-19 ECLS use over time may reflect improved therapies or management, less severe illness or a lack of ECMO availability in 2021 due to the return of hospital care to pre-pandemic levels. Many patients referred to our site were unable to receive ECMO in 2021 due to lack of nursing staffing or bed availability. CLINICAL IMPLICATIONS: Optimal use of ECMO and triage of patients require ongoing study and discussion. DISCLOSURE: Nothing to declare. KEYWORD: ECMO