Extracorporeal membrane oxygenation: experience in an adult medical ICU.
BACKGROUND
Extracorporeal membrane oxygenation (ECMO) is a technology that can provide extracorporeal gas exchange to patients with severe pulmonary or cardiac dysfunction. We report on our clinical experience with ECMO in critically ill patients.


METHODS
We performed a retrospective analysis of 23 patients treated with ECMO in a medical intensive care unit in a tertiary referral academic centre.


RESULTS
13 patients were considered immunocompetent and 10 were immunocompromised when extracorporeal membrane oxygenation was started. 16 patients presented with acute respiratory distress syndrome (ARDS), 2 patients had intractable cardiac failure, and 5 patients had combined respiratory and cardiac failure. In 16 patients, a veno-venous bypass was constructed; in 7 patients, the initial bypass was venoarterial. 11 patients survived. In 2 patients technical complications were fatal.


CONCLUSIONS
Our data indicate that patients with community-acquired pneumonia and no underlying disease will benefit most from this technique. However, long-term survival is possible in immunocompromised patients. Venoarterial bypass can carry a higher risk for technical complications. Increasing experience apparently also reduces the risk of technical complications.
Hermans
G
G
Medical Intensive Care Unit, Department of Internal Medicine, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium. Greet.Hermans@uz.kuleuven.ac.be
Meersseman
W
W
Wilmer
A
A
Meyns
B
B
Bobbaers
H
H
D000328:Adult; D000368:Aged; D002423:Cause of Death; D017714:Community-Acquired Infections / Q000150:complications; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011014:Pneumonia / Q000150:complications; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D010100:Oxygen