“Tough times never last, but tough people do”
Robert H. Schuller
The COVID-19 pandemic has resulted in challenges rarely if ever seen before. Not only are health care teams struggling to treat a viral illness with potentially devastating and lethal pulmonary complications but having to do so with limited resources and limited treatment options. In those patients with the most severe pulmonary injury, many centers have placed patients on extracorporeal membrane oxygenation (ECMO) hoping that it will support these patients while allowing the lungs to heal. Historically, ASAIO has been a leader as a society in the dissemination of information on ECMO from its annual meeting and journal. Thus, we feel obligated to continue to lead by publishing useful, timely and the most up-to-date information regarding the use of ECMO and other forms of mechanical support in this patient population. Together with our publisher, we have established a rapid publication process so that we can get the latest information online and available to our society members and the larger medical community treating this patient population. After initial online publication, these early clinical experiences and information from ELSO will be published in an upcoming print issue in a special section dedicated to the treatment of COVID-19.
Our first two publications will hopefully help current ECMO programs and centers that might need to transfer patients for more advanced care. Li et al.1 from Shanghai, China describe their initial experience treating COVID-19 patients that required ECMO. They give a detailed description of how their program is set up, patients managed, and suggestions for resource utilization. Not unexpectedly, the mortality is high, and the duration of support is long in those patients who were able to be weaned from ECMO.
The second publication is from ELSO outlining their initial Guidance Document for using ECMO in COVID-19 patients with severe cardiopulmonary failure.2 In an effort to get this information available as soon as possible, the document is also available on their website. The goal of publishing the Guidance Document as well is to get it in print and serve as a possible resource for the larger community that will be treating these patients. The other goal for this Guidance Document is that it can and will be updated as we gain clinical experience and start to identify what could be the best medical practice given the data at any given time. We encourage all ASAIO members that are part of an active ECMO program to submit their cases as they occur to the ELSO registry.
These are tough times, but I am convinced by witnessing the work and dedication of the health care providers not only in my own hospital but in hospitals worldwide, that we are up to the challenge and will succeed. The ASAIO Journal is committed to providing the most up to date information to help these health care teams stay safe and deliver the best care possible.
1. Li X, Guo Z, Li B, Zhang X, Tian R, et al. Extracorporeal membrane oxygenation for coronavirus disease 2019 in Shanghai China. ASAIO J. 2020.66: 475–481.
2. Bartlett RH, Ogino MT, Brodie D, McMullan DM, Lorusso R, et al. Initial ELSO guidance document: ECMO for COVID-19 patients with severe cardiopulmonary failure. ASAIO J. 2020.66: 472–474.