Extracorporeal Membrane Oxygenation Support for Interstitial Lung Disease in Idiopathic Inflammatory Myopathies: An ELSO Registry Analysis

Idiopathic inflammatory myopathies (IIM), including dermatomyositis (DM) and polymyositis (PM), have a reported mortality rate of 28.6% despite immunosuppressive therapies.1 IIMs are complicated by interstitial lung disease (ILD) in 41% of cases.2 ILD can be chronic or rapidly progressive (RP-ILD) and worsens outcomes with excess mortality of 40%.3 Intubated patients with IIM-ILD have mortality rates up to 90%, decompensating despite mechanical ventilation.4 Extracorporeal membrane oxygenation (ECMO) is a supportive therapy for cardiorespiratory failure refractory to invasive mechanical ventilation or vasoactive support. ECMO is initiated as a bridge to recovery (BTR) or bridge to transplantation (BTT). Literature regarding ECMO in IIM-ILD is sparse, but there have been successful outcomes with ECMO as both BTR and BTT, prompting our investigation of ECMO in patients with IIM-ILD.