SynthesisCritical care (London, England)2022
Evolving outcomes of extracorporeal membrane oxygenation during the first 2 years of the COVID-19 pandemic: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- 60 years of ARDS and the evolution of extracorporeal lung support - from ECMO to ECCOIntensive care medicine · 2026Review
- Frailty and outcomes after extracorporeal membrane oxygenation: a binational registry-based cohort study.Critical care (London, England) · 2025Article
- Kidney replacement therapy during extracorporeal membrane oxygenation: pathophysiology, technical considerations, and outcomes.Renal failure · 2025Review
- Missing the target in target trial emulation: the authors reply.Critical care (London, England) · 2025Article
- Left ventricular unloading during extracorporeal cardiopulmonary resuscitation: a target trial emulation of the ELSO registry.Critical care (London, England) · 2025Article
- Worldwide application and valuation of extracorporeal membrane oxygenation support during the COVID-19 pandemic (WAVES).Perfusion · 2025Article
- Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients.Metabolites · 2025Article
- Elderly patients in crisis: unveiling outcomes and management approaches in severe COVID-19 cases - a retrospective analysis from Brazil.Einstein (Sao Paulo, Brazil) · 2025Article
- In COVID-19 Patients Supported with Extracorporeal Membrane Oxygenation, Intensive Care Unit Mortality Is Associated with the Blood Transfusion Rate.Journal of clinical medicine · 2024Article
- Corticosteroid treatment in COVID-19 patients receiving extracorporeal membrane oxygenation: benefit from rational use - authors' reply.Annals of intensive care · 2024Article
- Immunomodulators in patients receiving extracorporeal membrane oxygenation for COVID-19: a propensity-score adjusted analysis of the ELSO registry.Annals of intensive care · 2024Article
- ECMO is associated with decreased hospital mortality in COVID-19 ARDS.Scientific reports · 2024Article
- Article
- The Respiratory Mechanics of COVID-19 Acute Respiratory Distress Syndrome-Lessons Learned?Journal of clinical medicine · 2024Review
- Risk Factors for the Mortality of Patients With Coronavirus Disease 2019 Requiring Extracorporeal Membrane Oxygenation in a Non-Centralized Setting: A Nationwide Study.Journal of Korean medical science · 2024Article
- ERS International Congress 2023: highlights from the Respiratory Intensive Care Assembly.ERJ open research · 2024Article
- Age and associated outcomes among patients receiving venovenous extracorporeal membrane oxygenation for acute respiratory failure: analysis of the Extracorporeal Life Support Organization registry.Intensive care medicine · 2024Article
- Persistent Critical Illness and Long-Term Outcomes in Patients With COVID-19: A Multicenter Retrospective Cohort Study.Critical care explorations · 2024Article
- Article
- Outcomes of ECMO support with polypropylene membrane during pandemic times: a retrospective cohort study.BMC pulmonary medicine · 2024Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtracorporeal membrane oxygenation (ECMO) has been used extensively for coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS). Reports early in the pandemic suggested that mortality in patients with COVID-19 receiving ECMO was comparable to non-COVID-19-related ARDS. However, subsequent reports suggested that mortality appeared to be increasing over time. Therefore, we conducted an updated systematic review and meta-analysis, to characterise changes in mortality over time and elucidate risk factors for poor outcomes.
methodsWe conducted a meta-analysis (CRD42021271202), searching MEDLINE, Embase, Cochrane, and Scopus databases, from 1 December 2019 to 26 January 2022, for studies reporting on mortality among adults with COVID-19 receiving ECMO. We also captured hospital and intensive care unit lengths of stay, duration of mechanical ventilation and ECMO, as well as complications of ECMO. We conducted random-effects meta-analyses, assessed risk of bias of included studies using the Joanna Briggs Institute checklist and evaluated certainty of pooled estimates using GRADE methodology.
resultsOf 4522 citations, we included 52 studies comprising 18,211 patients in the meta-analysis. The pooled mortality rate among patients with COVID-19 requiring ECMO was 48.8% (95% confidence interval 44.8-52.9%, high certainty). Mortality was higher among studies which enrolled patients later in the pandemic as opposed to earlier (1st half 2020: 41.2%, 2nd half 2020: 46.4%, 1st half 2021: 62.0%, 2nd half 2021: 46.5%, interaction p value = 0.0014). Predictors of increased mortality included age, the time of final patient enrolment from 1 January 2020, and the proportion of patients receiving corticosteroids, and reduced duration of ECMO run.
conclusionsThe mortality rate for patients receiving ECMO for COVID-19-related ARDS has increased as the pandemic has progressed. The reasons for this are likely multifactorial; however, as outcomes for these patients evolve, the decision to initiate ECMO should include the best contextual estimate of mortality at the time of ECMO initiation.
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