P-116 End of life care of patients on extracorporeal membrane oxygenation (ECMO) support

Abstract

BackgroundExtracorporeal membrane oxygenation (ECMO) is a well established, unique therapy for certain severe cardiorespiratory failure as well as in the setting of cardiac arrest. There is scarce literature on how end of life care is managed in patients who are receiving ECMO.AimThe aim of the study is to determine the methods that are used to manage patients who have had ECMO support withdrawn, including whether organ donation was raised. MethodsWe performed a retrospective study to review patient records over a 5 year period (2009–2013). Inclusion criteria include patients over the aged of 18, who have received ECMO and died.ResultsWe identified a large variability to time of death from the time of ECMO cessation. More than 50% of patients who had VA ECMO withdrawn, died within 60 min. Morphine and midazolam were commonly the drug of choice during the withdrawal period.DiscussionThere is a small variability in practice in different components during withdrawal of therapy in patients receiving ECMO. This could be related to physician’s preference, experience as well as family expectations.ConclusionThere was a consistent practice of ensuring comfort care for patients who have had ECMO withdrawn.