Modern ECMO: why an ECMO programme in a tertiary care hospital

Area of Science:

• Cardiovascular Medicine
• Respiratory Medicine
• Critical Care

Background:

• Extracorporeal Membrane Oxygenation (ECMO) is a vital life support tool for severe heart and lung failure.
• Individual centers often report suboptimal outcomes despite ECMO's potential.
• Specialized programs with trained staff and sufficient procedures may improve ECMO efficacy.

Purpose of the Study:

• To evaluate the impact of a dedicated Extracorporeal Membrane Oxygenation (ECMO) Programme at IRCCS PSD, instituted in 2012.
• To assess improvements in survival rates, blood loss, and blood consumption post-program implementation.
• To compare institutional outcomes with Extracorporeal Life Support Organization (ELSO) registry data.

Main Methods:

• Implementation of a dedicated ECMO program with specialized professionals and standardized procedures.
• Retrospective analysis of patient data including survival, blood loss, and blood consumption.
• Comparison of outcomes between pre- and post-program implementation periods and with ELSO registry data.

Main Results:

• The IRCCS PSD ECMO Programme demonstrated improved survival rates across all patient groups within one year of initiation.
• Outcomes were particularly enhanced in adult patients and surprisingly also in the pediatric population.
• The program's positive impact on patient outcomes has been sustained over time, with ongoing growth in treated patients.

Conclusions:

• A dedicated ECMO program significantly enhances patient survival and resource management.
• Specialized training and consistent procedural volume are critical for optimizing ECMO outcomes.
• Institutional ECMO programs can achieve superior results compared to broader registry data.