Evidence map›Paper›PMID 32987008›Full record

ArticleLancet (London, England)2020

Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry.

Ryan P Barbaro, Graeme MacLaren, Philip S Boonstra, Theodore J Iwashyna, Arthur S Slutsky, Eddy Fan, Robert H Bartlett, Joseph E Tonna, Robert Hyslop, Jeffrey J Fanning and 10 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 444 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
444citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

444 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  18. A Novel Method for Predicting Recirculation by Sweep-Gas Control in Extracorporeal Membrane Oxygenation.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2026
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384 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

Ryan P BarbaroDivision of Pediatric Critical Care Medicine and Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA. Electronic address: barbaror@med.umich.edu.
Graeme MacLarenCardiothoracic Intensive Care Unit, National University Health System, Singapore.
Philip S BoonstraSchool of Public Health Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Theodore J IwashynaDivision of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA.
Arthur S SlutskyInterdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada; Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
Eddy FanInterdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
Robert H BartlettDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Joseph E TonnaDivision of Cardiothoracic Surgery, University of Utah Health, Salt Lake City, UT, USA.
Robert HyslopHeart Institute, Children's Hospital Colorado, Aurora, CO, USA.
Jeffrey J FanningMedical City Children's Hospital, Dallas, TX, USA.
Peter T RycusExtracorporeal Life Support Organization, Ann Arbor, MI, USA.
Steve J HyerExtracorporeal Life Support Organization, Ann Arbor, MI, USA.
Marc M AndersBaylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
Cara L AgerstrandDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, and Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA.
Katarzyna HryniewiczMinneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.
Rodrigo DiazClinica Las Condes, Santiago, Chile.
Roberto LorussoDepartment of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.
Alain CombesSorbonne University, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris Sorbonne Hôpital Pitié-Salpêtrière, Paris, France.
Daniel BrodieDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, and Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA.
Extracorporeal Life Support Organization

Funding

ASCEND (ARDS in Children and ECMO initiation strategies impact on Neuro-Development)R01HL153519 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARBARO, RYAN PASQUALE · 2020 to 2024
$3.4M
Training to Advance Care Through Implementation Science in Cardiac And Lung Illnesses (TACTICAL)K12HL138039 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARNES, GEOFFREY DOUGLAS, PRESCOTT, HALLIE CHRISTINE · 2017 to 2021
$3.1M
Optimizing Selection and Management of Cardiac Arrest Patients Treated with ECMOK23HL141596 · NHLBI · UNIVERSITY OF UTAH · PI TONNA, JOSEPH EDWARD · 2018 to 2022
$945k
NHLBI NIH HHS K12 HL138039NHLBI NIH HHS K23 HL141596NHLBI NIH HHS R01 HL153519
6 · The paper itself

Abstract

backgroundMultiple major health organisations recommend the use of extracorporeal membrane oxygenation (ECMO) support for COVID-19-related acute hypoxaemic respiratory failure. However, initial reports of ECMO use in patients with COVID-19 described very high mortality and there have been no large, international cohort studies of ECMO for COVID-19 reported to date.

methodsWe used data from the Extracorporeal Life Support Organization (ELSO) Registry to characterise the epidemiology, hospital course, and outcomes of patients aged 16 years or older with confirmed COVID-19 who had ECMO support initiated between Jan 16 and May 1, 2020, at 213 hospitals in 36 countries. The primary outcome was in-hospital death in a time-to-event analysis assessed at 90 days after ECMO initiation. We applied a multivariable Cox model to examine whether patient and hospital factors were associated with in-hospital mortality.

findingsData for 1035 patients with COVID-19 who received ECMO support were included in this study. Of these, 67 (6%) remained hospitalised, 311 (30%) were discharged home or to an acute rehabilitation centre, 101 (10%) were discharged to a long-term acute care centre or unspecified location, 176 (17%) were discharged to another hospital, and 380 (37%) died. The estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 37·4% (95% CI 34·4-40·4). Mortality was 39% (380 of 968) in patients with a final disposition of death or hospital discharge. The use of ECMO for circulatory support was independently associated with higher in-hospital mortality (hazard ratio 1·89, 95% CI 1·20-2·97). In the subset of patients with COVID-19 receiving respiratory (venovenous) ECMO and characterised as having acute respiratory distress syndrome, the estimated cumulative incidence of in-hospital mortality 90 days after the initiation of ECMO was 38·0% (95% CI 34·6-41·5).

interpretationIn patients with COVID-19 who received ECMO, both estimated mortality 90 days after ECMO and mortality in those with a final disposition of death or discharge were less than 40%. These data from 213 hospitals worldwide provide a generalisable estimate of ECMO mortality in the setting of COVID-19.

fundingNone.

Indexed as

BetacoronavirusExtracorporeal Membrane OxygenationAdultCohort StudiesCoronavirus InfectionsCOVID-19Critical CareFemaleHospitalizationHospital MortalityHumansMaleMiddle AgedPandemicsPneumonia, ViralRegistries

Identifiers

PMID32987008
PMCPMC7518880

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.