(888) Initiating an ECMO Program at a Safety Net Hospital During a Global Pandemic

Purpose The COVID-19 pandemic resulted in a high incidence of respiratory failure requiring invasive management strategies including venovenous extracorporeal membrane oxygenation (VVECMO). COVID-19 infection resulted in more severe disease in patients with underlying comorbidities, such as those with limited access to healthcare. In this study, we describe our early experience with initiating a VVECMO program at a safety net hospital. Methods Prior to the COVID-19 pandemic, patients needing VVECMO at our safety net hospital were transferred to the adjacent affiliated university hospital for centralized care. To meet the growing need of VVECMO services during the COVID-19 pandemic, we implemented a multidisciplinary VVECMO program at the safety net hospital. Data were obtained from chart review. Categorical data are presented as numbers with proportions and continuous variables as medians with interquartile ranges. Results From January 2021 through January 2022, 25 patients with COVID-19 were placed on VVECMO. Complete background characteristics and outcomes data are shown in Table 1. Median ECMO run time was 962 hours [375-1371]. 15 (60%) survived to hospital discharge with a median length of stay of 65 days [37-87]. Survival by Kaplan Meier method is shown in Figure 1. Conclusion VVECMO for COVID-19 can be a lifesaving therapy despite a high frequency of complications and long hospital stays. Strategies to improve access to VVECMO for safety net hospitals and underserved patients are warranted.