ECLS | Extracorporeal Membrane Oxygenation

Registry Dashboard of ECMO-Supported COVID-19 Patient Data

Thank you for helping ELSO disseminate information by entering your experience in the ELSO Registry as soon as ECMO is implanted - before the run is complete. Instructions for entering data in the Registry and COVID-19 addendum can be found on the Data Definitions page.

We recognize you cannot complete and submit the entire ELSO Registry case report form prior to completion of the ECMO run and discharge from the hospital, but we would still like to have the data you know now.

To address concerns about incomplete data we report three nested data sets to accommodate the fact that different patients will be at different stages of care (and thus have more or less incomplete data). Also when considering the data please understand that the data displayed is a real-time data stream and subject to change as more patient information is accrued and as centers update the ELSO Registry Case Report Form and the ELSO COVID-19 addendum.



COVID-19 Cases on ECMO in the ELSO Registry

Total COVID-19 Cases COVID-19
Confirmed Cases
15,923
Total counts of COVID-19 confirmed patients.

COVID-19 ECMO counts by ELSO Chapter

Still on ECMO Still Hospitalized at ELSO Center Total (n)
All ELSO 456 764 16,000
          North America 137 239 10,264
          Europe 158 223 3,263
          Asia Pacific 29 60 371
          Latin America 94 169 1,041
          SWAAC 38 73 1,061
Reports counts of ECMO-supported suspected or confirmed COVID-19 cases by ELSO Chapter

Filters affect the data shown in the tables below:

Year To Date

Region

Patient Age


Patients who initiated ECMO at
least 90 days ago
COVID-19
Confirmed
14,619
COVID-19
In-hospital Mortality
47%

Outcomes

Pre-ECMO Patient Factors

Patient-level summaries of COVID ECMO runs. All categorical variables are given as 'percentage (count)'
Total ARDS Cohort
Number cases 14619 10928
Age(years)
Median(IQR) 47(37,56) 48(38,56)
# observed 14619 10928
BMI, kg/m2
Median(IQR) 32(28,38) 32(28,38)
# observed 13700 10229
Sex
Male 68%(10004) 70%(7625)
Female 32%(4611) 30%(3300)
# observed 14615 10925
Race/Ethnicity
Black 11%(1596) 10%(1145)
White (Non-Hispanic) 44%(6465) 44%(4776)
Asian 8%(1226) 8%(856)
Mid East, N African 4%(657) 5%(555)
Other 3%(432) 3%(320)
Unknown 5%(681) 5%(526)
Multiple 5%(679) 5%(578)
Hispanic 20%(2883) 20%(2172)
# observed 14619 10928
Pre-ECMO Comorbidities
No comorbidity 25%(3687) 24%(2621)
Cancer 2%(246) 2%(179)
Pregnancy 4%(608) 4%(461)
Immunocompromised 4%(652) 4%(486)
Diabetes 24%(3480) 25%(2693)
Pre-existing heart disease 4%(559) 3%(298)
Pre-existing lung disease 4%(543) 4%(411)
Pre-existing renal insuff. 3%(418) 3%(299)
Frailty 1%(119) 1%(69)
Asthma 10%(1513) 11%(1158)
BMI $> 30 \mathrm{kg}/\mathrm{m}^2$ 50%(7279) 52%(5685)
Hypertension 31%(4580) 32%(3546)
# observed 14619 10928
Acute illness
ARDS 79%(11548) 100%(10928)
Acute heart failure 8%(1172) 5%(546)
Myocarditis 2%(319) 1%(60)
Acute kidney injury 26%(3789) 27%(2907)
# observed 14619 10928
Pre-ECMO Cardiac Arrest
Yes 6%(870) 3%(320)
No 94%(13623) 97%(10510)
# observed 14493 10830
Pre-ECMO Co-Infection
No Co-infection 49%(7129) 46%(5059)
Bacterial pneumonia 44%(6492) 48%(5194)
Co-viral infection 9%(1370) 9%(989)
Blood stream infection 18%(2598) 19%(2062)
Urinary tract infection 8%(1101) 8%(909)
# observed 14617 10926

Pre-ECMO Interventions

Support and therapies. All categorical variables are given as 'percentage (count)'
PreECLS PreECLS
Number cases 14619 10928
Noninvasive ventilation
Noninvasive ventilation prior to intubation 77%(11218) 80%(8760)
BiPAP 38%(5604) 41%(4506)
CPAP 13%(1903) 12%(1335)
HFNC 52%(7533) 55%(6040)
# observed 14619 10928
Pre-ECLS intubation (days)
Median(IQR) 2.9(0.8,6.0) 3.2(1.0,6.2)
# observed 12342 9311
Ventilator mode
Conventional 96%(12132) 97%(9360)
# observed 12638 9649
PEEP, cm H2O
Median(IQR) 14.0(10.0,16.0) 14.0(10.0,16.0)
# observed 11312 8769
PIP, cm H2O
Median(IQR) 33.0(30.0,38.0) 34.0(30.0,38.0)
# observed 9105 7020
FiO2
Median(IQR) 1.00(0.95,1.00) 1.00(1.00,1.00)
# observed 11222 8564
PaO2/FiO2
Median(IQR) 70(57,91) 70(57,89)
# observed 10973 8381
PCO2
Median(IQR) 60(49,75) 61(51,75)
# observed 11642 8857
Pre-ECMO Support
Prone positioning 53%(7659) 57%(6153)
# observed 14563 10887
Neuromuscular blockers 68%(9946) 72%(7874)
# observed 14562 10883
Inhaled pulmonary vasodilators 29%(4180) 31%(3407)
# observed 14563 10887
Any vasoactive support 57%(8329) 56%(6089)
# observed 14557 10881
Norepinephrine 51%(7402) 51%(5535)
# observed 14557 10881
Therapies, Immunomodulators
Any therapy 88%(12831) 91%(9908)
Glucocorticoids 79%(11499) 82%(8922)
IVIG 3%(374) 2%(202)
Anti-cytokine 22%(3242) 24%(2651)
Lopinavir/Ritonavir 2%(265) 2%(220)
JAK inhibition 3%(499) 4%(420)
Chloroquine/hydroxychloroquine 7%(1011) 7%(817)
Remdesivir 49%(7102) 52%(5666)
# observed 14619 10928
Support type
Respiratory 93%(13667) 100%(10905)
Cardiac 5%(733) 0%(11)
ECPR 1%(219) 0%(12)
# observed 14619 10928

Patient Status & Complications

Outcomes
Total ARDS Cohort
Last known patient status
Discharged alive to home or acute rehabilitation 26%(3861) 26%(2827)
Discharged alive to long-term acute care or unspecified location 12%(1709) 13%(1383)
Discharged to another hospital 12%(1737) 11%(1217)
Remain in the hospital (discharged from ICU) 0%(9) 0%(7)
Remain in the ICU 0%(61) 0%(40)
In-hospital death 50%(7242) 50%(5454)
Tracheostomy 47%(6246) 51%(5069)
# observed 13367 10023
Select complications
Seizures 1%(108) 1%(80)
# observed 14553 10873
CNS infarction by US/CT/MRI 2%(239) 1%(148)
# observed 14553 10873
CNS hemorrhage by US/CT/MRI 6%(937) 7%(744)
# observed 14553 10873
Hemolysis 7%(1078) 8%(838)
# observed 14553 10873
Oxygenator failure 21%(3067) 23%(2538)
# observed 14553 10873
Pump failure 2%(317) 2%(253)
# observed 14553 10873
Circuit change 11%(1658) 12%(1327)
# observed 14553 10873
Thrombosis/Clots in circuit component 3%(490) 4%(393)
# observed 14553 10873
Discharge location
Home 31%(2238) 30%(1648)
Transfer to LTAC or Rehab
Transfer to another hospital 24%(1737) 22%(1217)
Other/Unknown 5%(389) 5%(267)
*N/A - Data elements with n<5 are not displayed.

ELSO Ownership, No Rights to Publication, Disclaimer

The Dashboard content has been compiled and reported from a variety of sources, is not independently verified by ELSO, and is subject to change without notice. ELSO and its authorized agents and contractors make no representations or warranties about the quality, content, completeness, suitability, adequacy, sequence, accuracy, or timeliness of such content. ELSO disclaims any responsibility for any inaccuracy, whether by inclusion or omission, on the Dashboard or the Site, and disclaims any responsibility for subsequent change or withdrawal of data shown on the Dashboard or the Site, which is subject to alteration without notice. ELSO disclaims any and all warranties regarding this information and all liability whatsoever relating thereto. Any person who uses information obtained from this Dashboard does so at his or her own risk.

The Dashboard is provided as a public service to facilitate real-time sharing of information during the COVID-19 crisis for educational purposes only by health practitioners. ELSO owns the compilation of all data, and its use or publication by any third party is strictly forbidden. Publication or representation of this information as if it were statistically significant or part of a scientific study is irresponsible and misleading.

The tables are consistent with the Lancet Publication article but the data presented here is real time

Barbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E, Bartlett RH, Tonna JE, Hyslop R, Fanning JJ, Rycus PT, Hyer SJ, Anders MM, Agerstrand CL, Hryniewicz K, Diaz R, Lorusso R, Combes A, Brodie D, the Extracorporeal Life Support Organization. Extracorporeal Membrane Oxygenation Support in COVID-19: The Registry Report from the Extracorporeal Life Support Organization. Lancet. 2020; [In Press].

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