ECMO Cannulation Criteria in COVID-19 (ECC-VID) and Obesity: A Literature Review and Retrospective Cohort Analysis

Author Info

Brian Hassani Christina Creel-Bulos Michael Connor Mark Caridi-Schieble Casey Miller Mani Danesmand Jeffrey Javidfar

Corresponding Author

Christina Creel-Bulos
Department of Anesthesiology, Division of Critical Care Medicine, Emory Critical Care Center, Emory University School of Medicine, Atlanta, Georgia, USA

A B S T R A C T

Veno-Venous Extracorporeal Membrane Oxygenation (V-V ECMO) continues to be used as rescue therapy for patients with acute respiratory distress syndrome (ARDS) secondary to coronavirus disease 2019 (COVID-19). Although there is emerging literature on the use of and mortality associated with V-V ECMO in the management of patients with COVID-19, our understanding of who may benefit from this management strategy remains limited. Our clinicians sought to provide further insight into pre-cannulation characteristics and mortality in a cohort of patients with COVID-19 associated ARDS managed with V-V ECMO that primarily consisted of obese patients (90%, n=18) with a BMI of 30 kg/m2 or greater. Our findings not only revealed high survival to hospital discharge (70%, n=14) but demonstrated non-inferior outcomes and survival in obese patients. With an imminent next wave of rising infections, knowledge of which patients have a better chance of survival with the initiation of V-V ECMO is essential. Obese patients have been historically underrepresented in ECMO outcomes literature, but our findings suggest the utilization of ECMO for COVID-19 associated ARDS in these patient subsets should be considered and outcomes should be further explored.

Article Info

Article Type

Research Article

Publication history

Received: Wed 21, Jul 2021
Accepted: Sat 07, Aug 2021
Published: Wed 25, Aug 2021

Copyright

© 2023 Christina Creel-Bulos. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2021.08.18