Study shows young, healthy adults died from COVID-19 due to ECMO
shortage

Date:
February 25, 2022
Source:
Vanderbilt University Medical Center
Summary:
Nearly 90 percent of COVID-19 patients who qualified for, but did
not receive, ECMO (extracorporeal membrane oxygenation) due to a
shortage of resources during the height of the pandemic died in
the hospital, despite being young with few other health issues,
according to a new study.



FULL STORY ========================================================================== Nearly 90 percent of COVID-19 patients who qualified for, but did not
receive, ECMO (extracorporeal membrane oxygenation) due to a shortage of resources during the height of the pandemic died in the hospital, despite
being young with few other health issues, according to a study published
in the American Journal of Respiratory and Critical Care Medicine.


==========================================================================
The Vanderbilt University Medical Center (VUMC) study, led by Whitney
Gannon, MSN, director of Quality and Education for the Vanderbilt Extracorporeal Life Support Program (ECLS), analyzed the total number
of patients referred for ECMO in one referral region between Jan. 1,
2021, and Aug. 31, 2021.

Approximately 90% of patients for whom health system capacity to provide
ECMO was unavailable died in the hospital, compared to 43% mortality
for patients who received ECMO, despite both groups having young age
and limited comorbidities.

"Even when saving ECMO for the youngest, healthiest and sickest patients,
we could only provide it to a fraction of patients who qualified for
it," Gannon said. "I hope these data encourage hospitals and federal authorities to invest in the capacity to provide ECMO to more patients."
Once a patient was determined to be medically eligible to receive ECMO,
a separate assessment was performed of the health system's resources to
provide ECMO.

When health system resources -- equipment, personnel and intensive care
unit beds -- were not available, the patient was not transferred to an
ECMO center and did not receive ECMO.



========================================================================== Among 240 patients with COVID-19 referred for ECMO, 90 patients (37.5%)
were determined to be medically eligible to receive ECMO and were included
in the study. The median age was 40 years and 25 (27.8%) were female.

For 35 patients (38.9%), the health system capacity to provide ECMO at
a specialized center was available; for 55 patients (61.1%), the health
system capacity to provide ECMO at a specialized center was unavailable.

Death before hospital discharge occurred in 15 of the 35 patients (42.9%)
who received ECMO, compared with 49 of the 55 patients (89.1%) who did
not receive ECMO.

"Throughout the pandemic, it has been challenging for many outside of
medicine to see the real-world impact of hospitals being 'strained' or 'overwhelmed,'" said co-author Matthew Semler, MD, assistant professor
of Medicine at VUMC.

"This article helps make those effects tangible. When the number of
patients with COVID-19 exceeds hospital resources, young, healthy
Americans die who otherwise would have lived." In total, the risk
of death for patients who received ECMO at a specialized center was approximately half of those who did not.

"Because some patients die despite receiving ECMO, there has been debate
about how much benefit it provides. This study shows the answer is a huge benefit," said senior author Jonathan Casey, MD, assistant professor of Medicine at VUMC.

"This data suggests that, on average, providing ECMO to two patients will
save a life and give a young person the potential to live for decades,"
he said.

The study was funded by NIH National Heart, Lung, and Blood Institute
grants K23HL153584 and K23HL143053.

========================================================================== Story Source: Materials provided by
Vanderbilt_University_Medical_Center. Original written by Craig
Boerner. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Whitney D. Gannon, John W. Stokes, Sean A. Francois, Yatrik
J. Patel,
Meredith E. Pugh, Clayne Benson, Todd W Rice, Matthew Bacchetta,
Matthew W Semler, Jonathan D Casey. Association Between Availability
of ECMO and Mortality in COVID-19 Patients Eligible for ECMO:
A Natural Experiment.

American Journal of Respiratory and Critical Care Medicine, 2022;
DOI: 10.1164/rccm.202110-2399LE ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220225123434.htm

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