ECMO is increasingly preferred to invasive ventilation in German ICUs in 2021.

We have analyzed the numbers of Robert Koch Institute and DIVI Intensive Care Register for 2021 to identify the treatment of Covid-19 patients in German ICUs. The data shows decreasing use of invasive ventilation and increasing use of High Flow, NIV and particularly ECMO (extracorporeal membrane oxygenation).

We observe COVID being a tailwind for ECMO, just as H1N1 was a driver in 2009. Still, there are barriers to wider adoption of the method. It requires more clinical personnel per patient than ventilation. Good practice for this treatment requires 1-to-1 nursing for each case, as patient mobility is important. Shortage of personnel is a major barrier. In addition, well-trained intensivists are needed to perform the vessel cannulation.