Unique Challenges for ECMO in this Pandemic
By Dr. Asif Saberi, Medical Director of Critical Care and ECMO at Wellstar Kennestone Regional Medical Center & Associate Professor of Medicine at Medical College of Georgia at Augusta State University
This wave of the pandemic is unique. We have learned a lot about COVID-19 as a disease, and we have more therapeutic options today than we did in the spring and summer of 2020. But the disease continues to humble us with its tenacity and increased deadliness with each new iteration or surge, and now with its onslaught on the young and the healthy, it is hitting us where it hurts the most.
As a system, we continue to struggle with limited human resources. There are not as many healthcare workers as we need and the steadfast warriors who have stayed at their posts through about 18 months of the pandemic are weary and burnout is high.
This is an important rate-limiting step in our ability to provide one specific therapy, viz., ECMO, which, for a significant number of young people in the extreme manifestation of the disease, is possibly the difference between life and death. At my institution, the phones have not stopped ringing and we maintain a long list of patients who need ECMO. The most heart-wrenching task for us is the daily sorting of our list, moving someone down and eventually off the list as their likelihood of benefit from ECMO and ultimately survival recedes with time.
This is a call to my colleagues in ECMO. Physicians, ECMO specialists, perfusionists, ethicists, and thinkers. As a breed, we are constantly thinking about solutions that are not in any book. Can we solve this problem?