I. Assessment
A. Policy and Research Question
Policy Question:
Should ECMO for COVID-19 patients with acute respiratory distress syndrome (ARDS) be recommended for use and covered by PhilHealth?
Research Questions:
Treatment guidelines and evidence synthesis on the use of ECMO
- Which country/countries have implemented ECMO for the management of ARDS secondary to COVID-19 infection?
- What is the current position/ recommendation of HTA agencies regarding the use of ECMO for the management of ARDS secondary to COVID-19 infection?
Clinical efficacy / effectiveness and safety
Among critically ill COVID-19 patients with acute respiratory distress syndrome, is ECMO alone or combined with mechanical ventilation compared to mechanical ventilation alone effective and safe in improving the survival rate, decreasing the hospitalization days, resolving the symptoms and decreasing the incidence of adverse events?
Resource requirements
What are the technical, infrastructure, logistical and organizational needs in implementing ECMO for COVID-19 patients with ARDS?
B. Protocol: Not available.
C. Reviewers: Health Technology Assessment Unit, DOH
D. Start of Review: July 24, 2020
E. End of Review: September 10, 2020
II. Recommendation
Evidence summary: Use of Extracorporeal Membrane Oxygenation (ECMO) for patients with Acute Respiratory Distress Syndrome (ARDS) in COVID-19
Rapid review: Use of Extracorporeal Membrane Oxygenation (ECMO) for patients with Acute Respiratory Distress Syndrome (ARDS) in COVID-19
III. Decision
Decision of the Secretary of Health: Signed HTAC Letter from Office of the Secretary on ECMO