Bridge to heart transplant falls short for patients on ECMO highlighting areas of improvement

Following recent guidance from healthcare regulating agencies to increase available extracorporeal membrane oxygenation (ECMO) devices in hospitals for use as an alternative to ventilators, the newest publishing in JACC showing that ventricular assist devices (VAD) devices outperform ECMO units in bridge to heart transplants reminds manufacturers and doctors about the risk factors associated with ECMO, says GlobalData, a leading data and analytics company.

In the study, patients that received VAD or ECMO as a bridge to heart transplant from 2005 to 2017 were evaluated. Five-year survival for patients that received VAD type devices was significantly higher (71-78%) than patients which received ECMO (61%).

Richard Hyde, Medical Analyst at GlobalData, comments: “ECMO use has more than tripled since 2010, and notably has increased use in cardiac procedures. Use of ECMO on COVID-19 patients is expected to lead to further use of ECMO in viral pneumonia. However, continuing this growth requires expanding ECMO use to other indications. Moonsamy et al. reminds us that ECMO use for longer than seven days is associated with higher mortality rates primarily due to onset of bleeding disorders, blood clots and infection.

“The ECMO circuit can be improved by using components that filter out inflammatory cytokines, manage platelet concentration and limit risk for sepsis. Further development and approval of these additions to the circuitry have the potential to mitigate risk factors associated with extended ECMO use, and appear to be the gateway to expanding the list of approved indications for ECMO use.”

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