Oxigenación por membrana extracorpórea poscardiotomía en la edad pediátrica: 119 pacientes en 20 años de experiencia

Aguilar, José Manuel Ruano; García, Enrique; Melo, Manuel; Rojas, Camilo; Belda, Sylvia; Llorente, Ana María Pinto; Garcia-Maellas, Mayte; Boni, Lorenzo

doi:10.1016/j.circv.2019.02.002

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“…4 Since then, several publications emphasize the importance of the number of patients treated with ECMO in a particular center, describing higher mortality rates in centers with less than 20-22 ECMOs/year, with others suggesting even higher numbers to guarantee better outcomes. [1][2][3] Our center uses ECMO since 1999, 18 with more than 250 cases to date, and an average survival rate of around 65% after decannulation. The transport team is task-specific and all members have extensive experience in ECMO support, which ensures their competence.…”

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confidence: 99%

Primary neonatal and pediatric ECMO transport: First experience in Spain

et al. 2023

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Introduction The organization of primary Extracorporeal membrane oxygenation (ECMO) transport is highly variable. Methods To present the experience of the first mobile pediatric ECMO program in Spain, we designed a prospective descriptive study of all primary neonatal and pediatric (0–16 years) ECMO transports carried out over 10 years. The main variables recorded include demographic information, patient background, clinical data, ECMO indications, adverse events, and main outcomes. Results 39 primary ECMO transports were carried out with a 66.7% survival to hospital discharge. The median age was 1.24 months[IQR: 0.09–96]. Cannulation was mostly peripheral venoarterial (33/39). The mean response time from the call from the sending center to the departure of the ECMO team was 4 h[2.2–8]. The median inotropic score at the time of cannulation was 70[17.2–206.5], with a median oxygenation index of 40.5[29–65]. In 10% of the cases, ECMO-CPR was performed. Adverse events occurred in 56.4%, mostly related to the means of transport (40% overall). On arrival at the ECMO center, 44% of the patients underwent interventions. The median PICU stay was 20.5 days[11–32]. 5 patients developed neurological sequels. Statistically significant differences between survivors and deceased patients were not found. Conclusions A good survival rate, with a low prevalence of serious adverse events, suggests a clear benefit of primary ECMO transport when conventional therapeutic measures are exhausted and the patient is too unstable to undergo conventional transport. A nationwide primary ECMO-transport program must therefore be offered to all patients regardless of their location.

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