Venovenous extracorporeal membrane oxygenation treatment in a low‐volume and geographically isolated cardiothoracic centre

• Published in: Acta Anaesthesiologica Scandinavica
• Main Authors: Ingvarsdottir, Inga L., Vidarsdottir, Halla, Valsson, Felix, Simonardottir, Liney, Sigurdsson, Martin I., Myrdal, Gunnar, Geirsson, Arnar, Gudbjartsson, Tomas
• Other Authors: Landspítali Research Fund, University of Iceland Research Fund
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2019
• Subjects: Iceland
• Online Access: http://dx.doi.org/10.1111/aas.13367; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Faas.13367; https://onlinelibrary.wiley.com/doi/pdf/10.1111/aas.13367; https://onlinelibrary.wiley.com/doi/full-xml/10.1111/aas.13367

Background Extracorporeal membrane oxygenation (ECMO) treatment is generally offered in large tertiary cardiothoracic referral centres. Here we present the indications and outcome of venovenous‐ECMO (VV‐ECMO) treatment in a low‐volume, geographically isolated single‐centre in Iceland, a country of 350 000 inhabitants. Our hypothesis was that patient survival in such a centre can be similar to that at high‐volume centres. Methods A retrospective study that included all patients treated with VV‐ECMO in Iceland from 1991‐2016 (n = 17). Information on demographics, indications and in‐hospital survival was collected from patient charts and APACHE II and Murray scores were calculated. Information on long‐term survival was collected from a centralized registry. Results Seventeen patients were treated with VV‐ECMO (nine males, median age 33 years, range 14‐74), the indication for 16 patients was severe acute respiratory distress syndrome, most often following pneumonia (n = 6), H1N1‐infection (n = 3) or drowning (n = 2). Median APACHE‐II and Murray‐scores were 20 and 3.5, respectively, and median duration of VV‐ECMO treatment was 9 days (range 2‐40 days). In total 11 patients (64,7%) survived the treatment, with 10 patients (58,8%) surviving hospital discharge, all of who were still alive at long‐term follow‐up, with a median follow‐up time of 9 years (August 15th, 2017). Conclusion Venovenous‐ECMO service can be provided in a low‐volume and geographically isolated centre, like Iceland, with short‐ and long‐term outcomes comparable to larger centres.