https://www.elso.org/Portals/0/Files/pdf/ECMO%20for%20COVID%2019%20Guidance%20Document.Final%2003.24.2020.pdf


Some centers reporting its use. IMO these pts (usually ARDS cytokine storm) are much too unstable to travel to OR for lines placed etc. None done so far at my hospital. Thoughts among others ?

We place patients on ECMO that are literally dead at my hospital (E-CPR candidates), so I'm not sure that instability would be much of an issue for us. I do not believe we have attempted ECMO yet, however, given that most of those that are currently intubated were not ECMO candidates to begin with (in their 80s, multiple co-morbidities, etc.).

Assuming these patients are being placed on ECMO for oxygenation issues, they would only require VV ECMO and those lines can be placed on the floor through the femoral and IJ. Even it's for cardiogenic shock and they require VA ECMO, our place has still placed those lines in the groin and then deal with decannulation in OR when stable. Haven't heard much in results of ECMO with Covid

ECMO is being used in a highly selective manner in very small numbers of patients at a few academic institutions. one patient with COVID is currently on ECMO at our center.

A big issue with ECMO is the high use of blood products at a time when blood donation is way down.

ECMO capacity in health systems is also minuscule compared to ventilator capacity- numbers of patients that can be on ECMO even in quaternary referral centers is usually less than 5% of ventilator capacity.