Investigating the Use of ECMO in Interstitial Lung Disease Associated with Dermatomyositis and Polymyositis

Background: Interstitial lung disease (ILD) can be a life-threatening complication for patients with dermatomyositis (DM) and polymyositis (PM). ILD can result in acute respiratory failure and carries high mortality rates. Extracorporeal membrane oxygenation (ECMO) may offer benefit as a bridge to lung transplant. Our aim is to investigate the use of ECMO in ILD associated with dermatomyositis and polymyositis.

Methods: A retrospective observational study was performed using deidentified data obtained from the Extracorporeal Life Support Organization (ELSO) registry. The data consisted of cases of dermatomyositis and polymyositis supported on ECMO between the years 2000-2020 and included patients of all ages. The primary outcome examined was survival to hospital discharge.

Results: 125 patients supported on ECMO were identified, 7 were excluded due to multiple ECMO runs or incomplete discharge information. There were 102 adults and 16 pediatric patients. 38/118 (32%) patients survived and there were no significant complications or comorbidities identified. Of the 118 total patients, 10 received lung transplants and 8/10 (80%) survived. Lung transplant patients were more likely to be discharged alive (p=0.002).

Conclusion: Patients with ILD associated with DM and PM have high mortality rates when they present in acute respiratory failure. ECMO can be a life-saving tool with minimal complications, when used as a bridge to transplant.