Only 1 in 10 U.S. hospitals offer a last-resort therapy for severely ill COVID-19 patients, a shortage that has forced providers to make difficult decisions about who should receive it, The New York Times reported July 12.
Five things to know:
1. Extracorporeal membrane oxygenation, or ECMO, entails using a machine to pump and oxygenate a patient's blood outside the body, allowing the heart and lungs to rest.
2. Less than 10% of hospitals offer the treatment, as it requires expensive equipment and specially trained staff to provide one-on-one care and constant monitoring, according to the Times.
3. The treatment's limited availability has forced physicians nationwide to make difficult decisions about which gravely ill patients should receive it.
"It's unsettling to have to make those kinds of decisions," Ryan Barbaro, MD, a critical care physician in Michigan and head of an international registry of COVID-19 patients who have received ECMO, told the Times.
4. During the pandemic, hospitals did not have regional sharing systems for ECMO to ensure equitable access and match resources with demand, the Times' reporting found. As a result, hospitals and physicians used various criteria to select patients who would most likely benefit from ECMO, with factors such as insurance coverage and geography coming into play.
"Patients died because they could not get ECMO," Lena M. Napolitano, MD, co-director of the surgical critical care unit at Ann Arbor-based Michigan Medicine, told the Times. "We could not accommodate all of them."
5. Some physicians still must ration ECMO. Erik Eddie Suarez, MD, a cardiovascular surgeon at Houston Methodist, said accepting too many COVID-19 patients for ECMO could prevent surgeons from performing cardiac surgeries, as some of those patients also need the treatment.
"It's something we're balancing every day," he told the Times.
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