Extubation of patients with COVID-19 acute respiratory failure during extracorporeal membrane oxygenation support is associated with improved survival

• DOI: 10.37349/ec.2025.101249
• Publication Date: 2025-02-05T05:15:20Z
• Authors: Sean Kelleher; Christoph Brehm; Carol Dziedzina; Shouhao Zhou; Catherine Nashed; Ricarda White; Miriam Freundt; Octavio Falcucci; Amit Prasad
• Keywords: Acute respiratory failure; Extracorporeal; 2019-20 coronavirus outbreak

Aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, infection resulting in distress (ARDS) requiring veno-venous veno-arterial extracorporeal membrane oxygenation (VV VA-ECMO) support is a life-threatening disease process that requires prolonged intubation and has high risk of mortality. Methods: In this retrospective, observational, single-center cohort study, we attempt to better understand the role extubation course treatment by dichotomizing groups into those extubated early while remaining on ECMO (group A), compared patients who remained intubated for entirety their B). Results: The data indicate with COVID-19-associated ARDS leads improved survival rates group A (93%) B) throughout therapy (64%) (p = 0.13). Additionally, earlier (19 days vs. 59 days; p 0.012) required significantly fewer vasoactive drugs (norepinephrine dosing: 0.03 mcg/kg/min 0.093 mcg/kg/min; 0.04), were less likely require tracheostomy (0 4, 0.026). Conclusions: Although utility severe remains contentious topic, seems increase overall patient outcomes support.