Machine that takes over when lungs, heart stop working is saving lives of critically sick coronavirus patients
A machine could help save the lives of critically sick coronavirus patients once the organs — lungs and hearts — shut down, suggests a new study.
The machine, called Extracorporeal Membrane Oxygenation (ECMO), can take over when the lungs and heart fail to carry out their functions. The machine infuses oxygen into the blood of the patient outside the body and then pumps it into the body.
Many doctors see this as a last-ditch effort to save lives. The new coronavirus is notorious for shutting down organs, especially the lungs and heart. In some cases, it damages the kidneys too.
The study looked at 32 critically sick patients placed on ECMO. Of them, 22 patients continue to stay alive. The survival rate stands at 68%.
The study comes amid reports of ventilators performing poorly as more patients are dying. The death rate in New York City Hospitals stands at 88%, according to data from the city.
ECMOs are not new. First invented in the 1930s, doctors have been using them since. During the 2009 H1N1 pandemic, the machine helped rescue infected patients.
According to the ELSO Registry, which maintains records of ECMO use, 221 patients in North American are on ECMO. Over 30% of those discharged are alive. A Japanese survey found patients on them survived more: 12 of at least 23 patients were alive.
In the new study, experts examined whether ECMO can rescue 32 critically sick patients from 9 different hospitals. Unfortunately, 10 of them died shortly after being placed on the machine. While 17 continue to remain on it, five patients are alive and free.
About 68% of them are alive, suggesting ECMOs are doing a better job of keeping patients alive. However, they maintain that each patient needs to be treated differently and on a case-by-case basis. Doctors must factor in age and other underlying conditions such as diabetes, heart disease and obesity among others.
The downsides of using ECMO are its high cost and labor. It also does not help that hospitals are already overwhelmed with patients.
"In a large outbreak, additional limitations to providing ECMO may include a lack of ECMO consoles or disposable equipment, suitably trained staff, or isolation rooms with the requisite infrastructure. Many materials necessary to make ECMO circuitry are manufactured in China and it is conceivable that the outbreak may disrupt supply chains," according to a JAMA viewpoint.
Earlier studies raise concerns
Experts have, however, expressed concerns over the use of ECMO. In one study, doctors saw a death rate of 83%. In other words, five out of 6 patients connected to the machine died.
The study "raises concerns about the potential harms of ECMO therapy for COVID-19," Dr Brandon Michael Henry from Cincinnati Children's Hospital Medical Center wrote in the Lancet.
He suspects ECMO could potentially lead to a drop in a type of cells that fight the invading microorganisms. "More reports are needed to understand the potential benefits or harms of extracorporeal life support in severe COVID-19 and future authors should be encouraged to provide more data for this subset of patients," he added.