ECMO-Kanülierung bei COVID-19: Venovenöse extrakorporale Membranoxygenierung bei COVID-19: Einfluss der Kanülierungsstrategie auf das Therapieergebnis

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) can cause a severe and therapy-refractory acute respiratory distress syndrome. Temporary mechanical assistance by veno-venous extracorporeal membrane oxygenation (v.v.-EMCO) is a well-established supportive therapy, but is still associated with a high mortality. OBJECTIVE: This work aimed to identify potential effects of the ECMO cannulation strategy on the outcome in COVID-19 patients. MATERIAL AND METHODS: All patients who were treated in a single center between March 2020 and November 2021 for COVID-19-related ARDS (n = 75) were prospectively entered into an institutional database. The patients were assigned into two groups with respect to the ECMO cannulation (femorofemoral: n = 20, femorojugular: n = 55) and the outcome was retrospectively analyzed. RESULTS: We observed severe therapy-related adverse events in both groups in more than 70% of patients with sepsis being the most common (> 50% each). The outcome (successful ECMO weaning, in-hospital death, 6‑month survival) was comparable in both groups. In-hospital mortality was about 70% each; however, the duration of event-free ECMO support seemed to be prolonged in the femorojugular group. CONCLUSION: Regardless of the support duration, v.v.-ECMO therapy for COVID-19 is associated with high mortality rates. The cannulation strategy did not impact on the outcome; however, femorojugular cannulation might prolong the event-free support duration and facilitate the mobilization of the patients during ECMO support.