Evidence map›Paper›PMID 34599878›Full record

ArticleLancet (London, England)2021

Extracorporeal membrane oxygenation for COVID-19: evolving outcomes from the international Extracorporeal Life Support Organization Registry.

Ryan P Barbaro, Graeme MacLaren, Philip S Boonstra, Alain Combes, Cara Agerstrand, Gail Annich, Rodrigo Diaz, Eddy Fan, Katarzyna Hryniewicz, Roberto Lorusso and 7 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 176 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
176citing papers in PubMed, 6 pooled it
28.7field-weighted citation impact, top 1% of its field
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

176 citing papers in PubMed, 6 syntheses or guidelines pooled it, 390 citations in OpenAlex.

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  16. Discordance between recovery and quality of life after ECMO for severe COVID-19.Proceedings (Baylor University. Medical Center) · 2026
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  20. Queensland adult ECMO retrieval service: A description of the service and analysis of outcomes.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026
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116 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 12 institutions in 7 countries.

Ryan P BarbaroDivision of Pediatric Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA. Electronic address: barbaror@med.umich.edu.
Graeme MacLarenCardiothoracic Intensive Care Unit, Department of Cardiac, Thoracic, and Vascular Surgery, National University Health System, Singapore.
Philip S BoonstraDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Alain CombesSorbonne Université, INSERM, UMRS1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, APHP Sorbonne Hôpital Pitié-Salpêtrière, Paris, France.
Cara AgerstrandDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, NY, USA; Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA.
Gail AnnichDepartment of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Rodrigo DiazClinica Las Condes, Santiago, Chile.
Eddy FanInterdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
Katarzyna HryniewiczMinneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.
Roberto LorussoDepartment of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.
Matthew L PadenDivision of Pediatric Critical Care, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA.
Christine M SteadExtracorporeal Life Support Organization, Ann Arbor, MI, USA.
Justyna SwolDepartment of Pneumology, Allergology and Sleep Medicine, Paracelsus Medical University, Nuremberg, Germany.
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.
Daniel BrodieDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, NY, USA; Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA.
Extracorporeal Life Support Organization
University of Michigan · USNewYork–Presbyterian Hospital · USAbbott Northwestern Hospital · USClínica Las Condes · CLEmory University · USHospital for Sick Children · CAInserm · FRMaastricht University Medical Centre · NLNational University Health System · SGParacelsus Medizinische Privatuniversität · DESt. Michael's Hospital · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver the course of the COVID-19 pandemic, the care of patients with COVID-19 has changed and the use of extracorporeal membrane oxygenation (ECMO) has increased. We aimed to examine patient selection, treatments, outcomes, and ECMO centre characteristics over the course of the pandemic to date.

methodsWe retrospectively analysed the Extracorporeal Life Support Organization Registry and COVID-19 Addendum to compare three groups of ECMO-supported patients with COVID-19 (aged ≥16 years). At early-adopting centres-ie, those using ECMO support for COVID-19 throughout 2020-we compared patients who started ECMO on or before May 1, 2020 (group A1), and between May 2 and Dec 31, 2020 (group A2). Late-adopting centres were those that provided ECMO for COVID-19 only after May 1, 2020 (group B). The primary outcome was in-hospital mortality in a time-to-event analysis assessed 90 days after ECMO initiation. A Cox proportional hazards model was fit to compare the patient and centre-level adjusted relative risk of mortality among the groups.

findingsIn 2020, 4812 patients with COVID-19 received ECMO across 349 centres within 41 countries. For early-adopting centres, the cumulative incidence of in-hospital mortality 90 days after ECMO initiation was 36·9% (95% CI 34·1-39·7) in patients who started ECMO on or before May 1 (group A1) versus 51·9% (50·0-53·8) after May 1 (group A2); at late-adopting centres (group B), it was 58·9% (55·4-62·3). Relative to patients in group A2, group A1 patients had a lower adjusted relative risk of in-hospital mortality 90 days after ECMO (hazard ratio 0·82 [0·70-0·96]), whereas group B patients had a higher adjusted relative risk (1·42 [1·17-1·73]).

interpretationMortality after ECMO for patients with COVID-19 worsened during 2020. These findings inform the role of ECMO in COVID-19 for patients, clinicians, and policy makers.

fundingNone.

Indexed as

AdultCOVID-19Duration of TherapyExtracorporeal Membrane OxygenationFemaleHospital MortalityHumansMaleMiddle AgedPatient SelectionPractice Guidelines as TopicRegistriesRespiratory Distress SyndromeSARS-CoV-2

Identifiers

PMID34599878
PMCPMC8480964
OpenAlexW3202915227

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.