Implementation and results of a new ECMO program for lung transplantation and acute respiratory distress.
OBJECTIVE
The development of the extracorporeal membrane oxygenation in Latin America represents a challenge in this specialty field. The objective of this article was to describe the results of a new extracorporeal membrane oxygenation program in an intensive care unit.


METHODS
This retrospective cohort study included 22 patients who required extracorporeal membrane oxygenation and were treated from January 2011 to June 2014. The baseline characteristics, indications, duration of the condition, days on mechanical ventilation, days in the intensive care unit, complications, and hospital mortality were evaluated.


RESULTS
Fifteen patients required extracorporeal membrane oxygenation after lung transplantation, and seven patients required oxygenation due to acute respiratory distress. All transplanted patients were weaned from extracorporeal membrane oxygenation with a median duration of 3 days (Interquartile range - IQR: 2 - 5), were on mechanical ventilation for a median of 15.5 days (IQR: 3 - 25), and had an intensive care unit stay of 31.5 days (IQR: 19 - 53) and a median hospital stay of 60 days (IQR: 36 - 89) with 20% mortality. Patients with acute respiratory distress had a median oxygenation membrane duration of 9 days (IQR: 3 - 14), median mechanical ventilation time of 25 days (IQR: 13 - 37), a 31 day stay in therapy (IQR: 11 - 38), a 32 day stay in the hospital (IQR: 11 - 41), and 57% mortality. The main complications were infections (80%), acute kidney failure (43%), bleeding at the surgical site and at the site of cannula placement (22%), plateletopenia (60%), and coagulopathy (30%).


CONCLUSIONS
In spite of the steep learning curve, we considered this experience to be satisfactory, with results and complications comparable to those reported in the literature.
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Eduardo
E
San Roman
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
María Sofía
MS
Venuti
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Nicolás Marcelo
NM
Ciarrocchi
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Ignacio
I
Fernández Ceballos
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Emiliano
E
Gogniat
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Sonia
S
Villarroel
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Federico Carlos
FC
Carini
Unidad de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Sergio Eduardo
SE
Giannasi
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult