SATS 2009 Final Program - Scandinavian Association for Thoracic ...

S06:6
ECMO - THE ICELANDIC EXPERIENCE
Astradsson Thorsteinn 1 , Torfason Bjarni 1 , Gudbjartsson Tomas 1 , Simonardottir Liney 1 , Valsson Felix 1
1) Landspitali University Hospital, Iceland
Background
Extracorporeal membrane oxygenation (ECMO) can prove lifesaving in severe respiratory failure (ARDS) and
cardiac failure (CF) refractory to conventional treatment. Because of the complicity and potential complications,
ECMO treatment has been limited to larger medical centers.
Aim
This study evaluates ECMO treatment in Iceland a small and relatively isolated community.
Results
18 patients have been treated with ECMO in Iceland from 1991. Nine of those had ARDS while the other 9 had
CF. Survival rate was 56% for both groups, the mean age of ARDS survivors was 20 compared to 50 years for
non-survivors while the mean age of CF survivors was 33 vs 49 years for the non-survivors. Mean pre-ECMO
ventilator time for ARDS survivors was 5,2 days (0,5-18) compared to 9,8 days (1-14) for ARDS non-survivors. One
of four ARDS patients with a pre-ECMO ventilator time longer than 7 days survived and four of five patient with
pre-ECMO ventilator time less than 7 days survived. CF survivors had lower APACHE II scores than non-surviving
CF patients (14 vs 32). One patient died from hemorrhage related to anticoagulation, while three other patients
survived significant hemorrhage. Recombinant factor VIIa was given to two patients both of which survived. All other
non-survivors succumbed to their underlying diseases.
Discussion
Survival rates (56%) in Iceland are similar to those seen in recent publications. No age limit or pre-ECMO ventilator
time limit has been implemented in Iceland. A stricter protocol regarding age and pre-ECMO ventilator time will be
enforced in future ECMO candidates in Iceland.
S06:7
EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT FOR 59 DAYS WITHOUT CHANGING THE
ECMO CIRCUIT
Thiara Amrit Singh 1 , Høyland Vivian 1 , Norum Hilde 1 , Aasmundstad Tor 1 , Karlsen Harald 1 , Fiane Arnt 1 , Geiran Odd 1
1) Rikshospitalet, Norway
Background
Veno-venous extracorporeal membrane oxygenation is an established support for the treatment of respiratory
failure. We report the successful use of veno-venous ECMO in a 53 year old patient with Legionella pneumonia and
acute respiratory distress syndrome (ARDS) with severe barotraumas.
He was admitted to intensive care unit. His clinical course deteriorated, despite the continuous support with
mechanical ventilation.
Interventions
He was placed on veno-venous ECMO for lung rest and while awaiting a response to continued medical treatment.
He was supported by ECMO for 59 days without any changes in the ECMO circuit. There were no complications
with the ECMO circuit during the support period.
Conclusion
ECMO can provide a chance of survival even in severe case of ARDS. This is likely the longest support ever reported
using the same oxygenator.
STOCKHOLM, SWEDEN 51