First Experience with Extracorporeal Membrane Oxygenation in Iran, under Difficult Conditions

Area of Science:

• Cardiology
• Critical Care Medicine
• Biomedical Engineering

Background:

• Extracorporporeal membrane oxygenation (ECMO) is vital for hemodynamic and oxygenation support in critical care.
• Iran faced severe economic constraints impacting medical equipment imports during ECMO program initiation.
• Sanction-related limitations necessitated innovative solutions for ECMO program sustainability.

Purpose of the Study:

• To evaluate the feasibility and safety of integrating ECMO components from different manufacturers.
• To assess the outcomes of ECMO therapy under resource-limited conditions.
• To identify factors associated with ECMO success and failure in a sanctioned economy.

Main Methods:

• Retrospective study at Masih Daneshvari Medical Center (2010-2015).
• Integration of Medtronic or Stöckert pump consoles with Maquet oxygenators.
• Multivariate logistic regression analysis to determine factors influencing ECMO outcomes.

Main Results:

• 37.1% of patients were successfully weaned off ECMO, a rate comparable to previous studies.
• 35.4% overall survival to hospital discharge.
• Younger age and shorter ECMO duration were significantly associated with survival.
• Sepsis and multisystem organ failure were leading causes of death.

Conclusions:

• Combining ECMO components from different manufacturers is a safe and viable strategy, especially during resource limitations.
• This approach can sustain ECMO programs under economic sanctions.
• Further research may explore long-term outcomes of such integrated systems.