2020 8(11):1121–31.īarbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E, Bartlett RH, Tonna JE, Hyslop R, Fanning JJ, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome associated with COVID-19: a retrospective cohort study. Schmidt M, Hajage D, Lebreton G, Monsel A, Voiriot G, Levy D, Baron E, Beurton A, Chommeloux J, Meng P, et al. Therefore, age limits should be viewed with caution and decisions for or against the use of ECMO for patients above 70 years of age should be performed on an individual case-by-case level. Moreover, even though 90-day-survival of patients aged ≥ 71 years was significantly lower than for patients < 71 years, not all treatments in this elderly population ended fatal.
Our results therefore challenge strict contraindications for initiation of ECMO in COVID-19 patients solely based on duration of MV. Even though survival of patients treated with ECMO even after longer periods of time of MV was lower than survival of patients with early initiation of ECMO, the latter still showed considerable survival rates. The lower survival rate might be attributable to a more liberal use of V-V ECMO in this real-world cohort outside a prospective trial or to a different policy than in other ECMO centers. 90-day survival in our cohort was 41.7%, which was lower than previously described for COVID-19 patients treated with V-V ECMO in large registries and survival reported for non-COVID-19 ARDS patients. Our findings derive from an international multicenter registry of COVID-19-related ARDS patients treated with V-V ECMO.
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