• HayangaJ W AworiJWADepartment of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa. Electronic address: jeremiah.hayanga@wvumedicine.org., Jahnavi Kakuturu, Ankit Dhamija, Fatima Asad, Paul McCarthy, Penny Sappington, and Vinay Badhwar.
• Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa. Electronic address: jeremiah.hayanga@wvumedicine.org.
• J. Thorac. Cardiovasc. Surg. 2023 Oct 1; 166 (4): 11321142.e331132-1142.e33.

ObjectiveWe compared outcomes in patients with severe COVID-19 versus non-COVID-19-related acute respiratory distress syndrome (ARDS) managed using a dynamic, goal-driven approach to venovenous extracorporeal membrane oxygenation (ECMO).MethodsWe performed a retrospective, single-center analysis of our institutional ECMO registry using data from 2017 to 2021. We used Kaplan-Meier plots, Cox proportional hazard models, and propensity score analyses to evaluate the association of COVID-19 status (COVID-19-related ARDS vs non-COVID-19 ARDS) and survival to decannulation, discharge, tracheostomy, and extubation. We also conducted subgroup analyses to compare outcomes with the use of extracorporeal cytoreductive techniques (CytoSorb [CytoSorbents Corp] and plasmapheresis).ResultsThe sample comprised 128 patients, 50 with COVID-19 and 78 with non-COVID-19 ARDS. Advancing age was associated with decreased probability of survival to decannulation (P = .04). Compared with the non-COVID-19 ARDS group, patients with COVID-19 had a greater probability of survival to extubation (P < .01) and comparable survival to discharge (P = .14).ConclusionsPatients with COVID-19 managed with ECMO had comparable outcomes as patients with non-COVID ARDS. A strategy of early extubation and ambulation might be a safe and effective strategy to improve outcomes and survival, even for patients with severe COVID-19.Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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