title: Extracorporeal life support: first year of experience implementing the technique in Slovenia.
abstract: Extracorporeal life support (ELS) is emerging as a standard treatment option for acute respiratory and/or cardiac failure. In this article we describe our first year of experience with ELS activity in adult medical patients in our center. Veno-venous extracorporeal membrane oxygenation (VV ECMO) support was applied in cases of severe acute respiratory distress syndrome (ARDS) not responsive to conventional treatments. The use of veno-arterial (VA) ECMO support was reserved for cases of cardiac shock refractory to standard treatment and cardiac arrests not responding to conventional resuscitation. A total of 19 patients were treated with ELS during the first year of activity. Eight of these received VV ECMO for ARDS of various etiologies, with a survival rate of 63%. Eleven patients received VA ECMO support due to cardiac failure (2 post-resuscitation). Survival in this group was 45%. We report our results, including complications and organizational issues that we encountered, and describe protocol improvements developed over the short period of time since ELS treatment has been implemented in our center.
authors.affiliation: Department of Intensive Internal Medicine, University Clinical Center Ljubljana, Ljubljana - Slovenia.
authors.forename: Alenka
authors.initials: A
authors.lastname: Golicnik
authors.forename: Ivan
authors.initials: I
authors.lastname: Knezevic
authors.forename: Marija
authors.initials: M
authors.lastname: Racic
authors.forename: Marko
authors.initials: M
authors.lastname: Noc
authors.forename: Vojka
authors.initials: V
authors.lastname: Gorjup
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D008021:Life Support Systems; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015397:Program Evaluation; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000401:mortality / Q000628:therapy*; D017524:Slovenia; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult