Role of invasive mechanical ventilation and ECMO in the management of COVID-19: a systematic review

Nagraj, Sanjana, Karia, Rutu, Hassanain, Sahar, Ghosh, Prithwish, Shah, Viraj R. and Thomas, Abin ORCID: https://orcid.org/0000-0002-8283-6762 2021. Role of invasive mechanical ventilation and ECMO in the management of COVID-19: a systematic review. Indian Journal of Critical Care Medicine 25 (6) , pp. 691-698. 10.5005/jp-journals-10071-23870

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Abstract

Objectives: This systematic review aims to provide insight into the outcome of extracorporeal membrane oxygenation (ECMO) and invasive mechanical ventilation use in critically ill COVID-19 patients. Data sources: Electronic databases PubMed Central and PubMed were searched from January 2020 to June 2020 for published studies about ECMO and/or invasive mechanical ventilation use in COVID-19 patients. Data Extraction and Study Selection: The search strategy retrieved 766 articles, of which 19 studies consisting of 204 patients fulfilled the inclusion criteria and were included in the analysis. Data synthesis: Primary outcomes evaluated were discharge and/or clinical improvement and mortality rate. Secondary outcomes evaluated included reported complications and the mean number of days of hospitalization for survivors. Weighted averages of included studies were calculated, and data were pooled in forest plots. Nearly, 68.1% of the patients received invasive mechanical ventilation without ECMO support, and 31.9% were placed on ECMO. Also, 22.5% of the patients were discharged and/or clinically improved and 51.5% died. Twenty-six percent of the study population deteriorated but remained alive or experienced no improvement in clinical condition. And 75.2% of those who died belonged to the non-ECMO group and 24.8% to the ECMO group. The mortality rate in the non-ECMO group was 56.8% compared to 40% in the ECMO group. Conclusion: The utility of ECMO during a pandemic is uncertain as it is a resource-intensive modality, especially when the mortality rate in severely ill patients infected with COVID-19 virus is already known to be high.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	s This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/)
Publisher:	Medknow Publications
ISSN:	0972-5229
Date of First Compliant Deposit:	16 February 2022
Date of Acceptance:	1 June 2021
Last Modified:	23 May 2023 16:59
URI:	https://orca.cardiff.ac.uk/id/eprint/147554

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