Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study

ETALON Study Grp, Senta Jorinde Raasveld, Thijs S. R. Delnoij, Lars M. Broman, Annemieke Oude Lansink-Hartgring, Greet Hermans, Erwin De Troy, Fabio S. Taccone, Manuel Quintana Diaz, Franciska van der Velde, Dinis Dos Reis Miranda, Erik Scholten, Alexander P. J. Vlaar*

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    To report and compare the characteristics and outcomes of COVID-19 patients on extracorporeal membrane oxygenation (ECMO) to non-COVID-19 acute respiratory distress syndrome (ARDS) patients on ECMO.


    We performed an international retrospective study of COVID-19 patients on ECMO from 13 intensive care units from March 1 to April 30, 2020. Demographic data, ECMO characteristics and clinical outcomes were collected. The primary outcome was to assess the complication rate and 28-day mortality; the secondary outcome was to compare patient and ECMO characteristics between COVID-19 patients on ECMO and non-COVID-19 related ARDS patients on ECMO (non-COVID-19; January 1, 2018 until July 31, 2019).


    During the study period 71 COVID-19 patients received ECMO, mostly veno-venous, for a median duration of 13 days (IQR 7-20). ECMO was initiated at 5 days (IQR 3-10) following invasive mechanical ventilation. Median PaO2/FiO(2) ratio prior to initiation of ECMO was similar in COVID-19 patients (58 mmHg [IQR 46-76]) and non-COVID-19 patients (53 mmHg [IQR 44-66]), the latter consisting of 48 patients. 28-day mortality was 37% in COVID-19 patients and 27% in non-COVID-19 patients. However, Kaplan-Meier curves showed that after a 100-day follow-up this non-significant difference resolves. Non-surviving COVID-19 patients were more acidotic prior to initiation ECMO, had a shorter ECMO run and fewer received muscle paralysis compared to survivors.


    No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19.

    Original languageEnglish
    Pages (from-to)910-917
    Number of pages8
    JournalJournal of Intensive Care Medicine
    Issue number8
    Early online date7-Apr-2021
    Publication statusPublished - 1-Aug-2021


    • survival
    • ECMO
    • COVID-19
    • ARDS

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