A Review of COVID-19 Extracorporeal Membrane Oxygenation Transport

INTRODUCTION: Use of extracorporeal membrane oxygenation (ECMO) has been a transport standard of care for cardiovascular and pulmonary compromised patients. However, implementation and associated outcomes for unstable patients diagnosed with SARS-COV-2 infection has not been documented. METHODS: A retrospective chart review was performed examining ECMO transports of patients with SARS-COV-2 infection from April 2020- October 2021 involving one healthcare transport program. Variables of interest included: pH pre-post cannulation, BMI, pre-existing health conditions, medications utilized, and health outcomes. Descriptive statistics was used to analyze the data. RESULTS: 21 transports were completed involving North Carolina and South Carolina referral facilities: 15 ground ambulance and 6 EC-145 rotor wing aircraft. All patients were cannulated at outside hospitals, with 2 performed by the transport team. While there were no complications during transport, trends illustrated those patients persistently acidotic (pH< 7.35) after ECMO cannulation were more likely to die.8 of the 10 patients who died had persistently low pH, versus the survivors where only 3 of 11 had persistently low pH after cannulation. This was a statistically significant difference in survival outcomes for those with sustained normal pH after cannulation, p=0.03. BMI had no statistically significant influence on outcomes, p=0.08. CONCLUSION: Transportof patients on ECMO with SARS-COV-2 virus infection is safe and effective with a specialty transport team. The significance between post-ECMO cannulation pH and patient outcomes requires further examination which may aid in patient management.