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: 1 Department of Anaesthesiology and Intensive Care, Landspitali University Hospital, Reykjavik, Iceland. 2 Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. 3 Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2019
• Subjects: acute lung injury; acute respiratory distress syndrome; extracorporeal life support; extracorporeal membrane oxygenation; survival; venovenous ECMO; Iceland
• Online Access: http://hdl.handle.net/2336/621061; https://doi.org/10.1111/aas.13367

To access publisher's full text version of this article click on the hyperlink below 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. Landspitali Research Fund University of Iceland Research Fund