ECMO Registries in COVID-19 patients
EuroECMO-COVID Survey :
It is an initiative of the Steering Committee of the European chapter of the Extracorporeal Life Support Organization (Euro-ELSO) to obtain weekly information on the use of ECMO in European and Israel centers in complicated COVID-19 patients. The survey started on March 15, 2020; as of July 17, and with 1,387 patients collected, the survey reflected 160 ECMO implants in 26 centers in Spain, ranking third in Europe in number of implants, behind France (367 devices) and Germany (165 devices).
ECMO-COVID Spanish Registry :
An ECMO Implant Registry for COVID-19 patients (coordinator: Dr. Mario Castaño, León, Spain), was created and is managed by the SECCE and its Mechanical Circulatory Support Working Group.
Based on the EuroECMO-COVID Survey and directly exportable to it, the Spanish registry is somewhat more ambitious. It includes analytic parameters and prognostic severity markers (D-dimer, procalcitonin, C-reactive protein, ferritin, etc.) collected during the time of ECMO support as well as other in-ICU management variables. Altogether 100 variables are collected in a secure database accessible online, allowing the inclusion of every patient and updates during follow-up.
Data collection started at the beginning of April. As there are still newly diagnosed cases every day, the registry remains open and there are no preliminary analyses or provisional data. The results will be published in the near future. We can now give only an incomplete view of the information collected, not in the form of official publication.
As of June 30, the registry collected more than 110 patients from 24 different centers; 90% of the cases were V-V ECMO implanted with the femoral-jugular configuration in two-thirds of the cases. The configuration was changed to V-A ECMO or upgraded (V-VA or VV-A) in up to 10% of patients, due to oxygenation problems or ventricular failure. The indication was ARDS/pneumonia in almost 90% of patients; the remaining corresponded to myocarditis, heart failure, barotrauma, or an association of them.
Today, more than 50% of patients have been successfully weaned from ECMO and almost 20% more are still on support; of all with completed follow-up, 55% were discharged from the hospital. The closing date of the registry has yet to be decided and therefore the final data of each patient are still not available.