ECMO therapy in COVID-19: The Zurich experience.

Sromicki, Juri; Schmiady, Martin; Maisano, Francesco; Mestres, Carlos A

BACKGROUND The current coronavirus disease 2019 (COVID-19) pandemic has a huge impact on society and the economy and represents one of the biggest challenges for healthcare systems all over the world. Reports from healthcare institutions in different countries show a variety of crisis exit strategies. METHODS The following is a review and update of the situation and crisis management in Zürich and Switzerland with a special focus on the impact on the cardiac surgery program and extracorporeal membrane oxygenation (ECMO)-therapy in COVID-19. RESULTS Regional and national measures had avoided the collapse of the health system in Switzerland. There was a reduction of over 50% of the surgical and transcatheter caseload during the first wave of the pandemic. Twenty-three ECMO devices, 150 oxygenators, and more than 300 different cannulas were at our disposal. Between March and May 2020, nine COVID-19 patients were treated by us with ECMO-therapy. Three patients were transported by us from distant institutions. Median age at ECMO implantation was 59 years. Two patients died on support. CONCLUSIONS Measures to prevent a collapse of the healthcare system were effective. Our local ECMO-Program on the ongoing COVID-19 pandemic has proven to be a useful tool to control mortality and organ failure in critically ill patients.