Extracorporeal Life Support Organization Registry International Report 2022: 100,000 Survivors

Author:

Tonna Joseph E.12,Boonstra Philip S.3ORCID,MacLaren Graeme4ORCID,Paden Matthew5,Brodie Daniel6ORCID,Anders Marc7,Hoskote Aparna89ORCID,Ramanathan Kollengode1011ORCID,Hyslop Rob12,Fanning Jeffrey J.13,Rycus Peter14ORCID,Stead Christine15,Barrett Nicholas A.1617ORCID,Mueller Thomas18ORCID,Gómez Rene D.19ORCID,Malhotra Kapoor Poonam20ORCID,Fraser John F.21ORCID,Bartlett Robert H.22,Alexander Peta M.A.2324ORCID,Barbaro Ryan P.62526ORCID,

Affiliation:

1. From the Division of Cardiothoracic Surgery, Department of Surgery, University of Utah Health, Salt Lake City, Utah

2. Department of Emergency Medicine, University of Utah Health, Salt Lake City, Utah

3. Department of Biostatistics, University of Michigan, Ann Arbor, Michigan

4. Department of Surgery, National University Hospital, Singapore, Singapore

5. Department of Surgery, Division of Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia

6. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland

7. Department of Surgery, Division of Critical Care, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas

8. Department of Surgery, Heart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

9. Department of Surgery, Institute of Cardiovascular Science, University College London, Zayed Centre for Research into Rare Diseases in Children, London, UK

10. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

11. Department of Surgery, Cardiothoracic Intensive Care Unit, National University Heart Centre, National University Hospital, Singapore, Singapore

12. Department of Surgery, Heart Institute, Children’s Hospital Colorado, Aurora, Colorado

13. Department of Pediatrics, Extracorporeal Life Support Program, Medical City Children’s Hospital, Dallas, Texas

14. Department of Surgery, Extracorporeal Life Support Organization (ELSO), Ann Arbor, Michigan

15. Department of Surgery, Extracorporeal Life Support Organization (ELSO), University of Michigan, Ann Arbor, Michigan

16. Department of Critical Care, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

17. Department of Surgery, Centre for Human & Applied Physiological Sciences, King’s College London, London, UK

18. Intensive Care Medicine, Department of Internal Medicine II, University Hospital Regensburg, Germany

19. Department of Surgery, Terapias Avanzadas de Soporte Cardiopulmonar, Hospitales Tec Salud, Escuela de Medicina ITESM, Monterrey, Mexico

20. Department of Cardiac Anaesthesiology and Critical Care, Cardio Thoracic Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India

21. Department of Surgery, University of Queensland, The Prince Charles Hospital, Brisbane, Australia

22. Department of Surgery, University of Michigan, Ann Arbor, Michigan

23. Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts

24. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts

25. Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan; and

26. Department of Surgery, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan.

Abstract

The Extracorporeal Life Support Organization (ELSO) maintains the world’s largest extracorporeal membrane oxygenation (ECMO) registry by volume, center participation, and international scope. This 2022 ELSO Registry Report describes the program characteristics of ECMO centers, processes of ECMO care, and reported outcomes. Neonates (0–28 days), children (29 days–17 years), and adults (≥18 years) supported with ECMO from 2009 through 2022 and reported to the ELSO Registry were included. This report describes adjunctive therapies, support modes, treatments, complications, and survival outcomes. Data are presented descriptively as counts and percent or median and interquartile range (IQR) by year, group, or level. Missing values were excluded before calculating descriptive statistics. Complications are reported per 1,000 ECMO hours. From 2009 to 2022, 154,568 ECMO runs were entered into the ELSO Registry. Seven hundred and eighty centers submitted data during this time (557 in 2022). Since 2009, the median annual number of adult ECMO runs per center per year increased from 4 to 15, whereas for pediatric and neonatal runs, the rate decreased from 12 to 7. Over 50% of patients were transferred to the reporting ECMO center; 20% of these patients were transported with ECMO. The use of prone positioning before respiratory ECMO increased from 15% (2019) to 44% (2021) for adults during the coronavirus disease-2019 (COVID-19) pandemic. Survival to hospital discharge was greatest at 68.5% for neonatal respiratory support and lowest at 29.5% for ECPR delivered to adults. By 2022, the Registry had enrolled its 200,000th ECMO patient and 100,000th patient discharged alive. Since its inception, the ELSO Registry has helped centers measure and compare outcomes across its member centers and strategies of care. Continued growth and development of the Registry will aim to bolster its utility to patients and centers.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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