1 - Extracorporeal Life Support Organisation of the South and West Asia Chapter 2017 Conference Proceedings
  • ISSN: 0253-8253
  • EISSN: 2227-0426


Survival following extracorporeal membrane oxygenation (ECMO) has steadily improved over the past decade owing to better knowledge and training.1,2 The objective of our study is to identify the predictors and trend of in-hospital morbidity and mortality during our initial experience. After obtaining an DSREC (Dubai Scientific Research Ethics Committee) review and exemption, we collected the clinical data of patients from May 2013 to November 2016 and analyzed for baseline characteristics, indication, type, undergoing cardiopulmonary resuscitation (CPR) or not, duration of ECMO treatment, morbidity, and mortality. A total of 24 adults received ECMO (18 M/6 F), of which 22 were supported with veno-arterial (VA) ECMO and the remaining were converted from VA to veno-venous (VV) ECMO during the course of their treatment. There were 8 (6 M/2 F) survivors (30%) with two bridged for left ventricular assist device (LVAD) and one for heart transplant. The mortality pattern as shown in Figure 1 shows a consistent improvement of more than 50% from mid-2015. Weaning was overall successful in 30% of surgical and 38% of medical patients. CPR was necessary in 12 patients, none from the survivor group. The minimum to maximum duration of ECMO was 53–483 hours in the survivors versus 2–528 hours in the non-survivors, of which 8 (50%) survived less than 24 hours on ECMO. The most frequent complications were bleeding from catheterization or surgical site (58.3%), renal failure (29.1%), GI bleeding (20.8%), and leg ischemia (12.5%). Two patients had raised bilirubin and one altered response to medication, resulting in hypertension and bleeding.3 The percentage among survivors to non-survivors with reference to bleeding was 38% vs. 69%, leg ischemia 0% vs.18%, renal failure 12.5% vs. 37.5%, and GI bleeding 12.5% vs. 31.2%.Figure 1.  Mortality rate of ECMO patients at Dubai Hospital from 2013 to 2016.

In spite of a steep learning curve, a remarkable improvement in the reduction of mortality was achieved during the latter half of the term possibly due to better understanding, education, and training. The survival during this interval compared well with the previous results and Extracorporeal Life Support Organization (ELSO) reports.4,5 The percentage of complications and the number of patients requiring CPR were less in the survivors' group, indicating that early referral and prevention of ECMO complications are equally important. These two elements could be the key to our success in the management of these patients.


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  1. Miano LA, Caneo LF, Tanamati C, Penha JG, Guimaraes VA, Miura N, Galas FR, Jatene MB. Post-cardiotomy ECMO in paediatric and congenital heart surgery: Impact of team training and equipment in the results. Rev Bras Cir Cardiovasc. 2015; 30:4:409416.
    [Google Scholar]
  2. Kim GW, Koh Y, Lim CM, Huh JW, Jung SH, Kim JB, Hong SB. The effect of an improvement of experience and training in extracorporeal membrane oxygenation management on clinical outcomes. Korean J Intern Med. 2016 Mar 25;. Available from: doi:https://doi.org/10.3904/kjim.2015.027 [Accessed 11 January 2017].
    [Google Scholar]
  3. Khazi FM, AlJassim O, AzizTarek A, Robert S, Elhoufi A. Unusual drug response and hemodynamics, VA – ECMO. A case report. Egypt J Crit Care Med. 2016; 4:1:3738, Available from: doi:http://dx.doi.org/10.1016/j.ejccm.2016.02.003 [Accessed 10 January 2017].
    [Google Scholar]
  4. Saxena P, Neal J, Joyce LD, Greason KL, Schaff HV, Guru P, Shi WY, Burkhart H, Li Z, Oliver WC, Pike RB, Haile DT, Schears GJ. Extracorporeal membrane oxygenation support in postcardiotomy elderly patients: Mayo Clinic experience. Ann Thorac Surg. 2015; 99::20532060.
    [Google Scholar]
  5. Paden ML, Conrad SA, Rycus PT, Thiagarajan R. Extracorporeal Life Support Organization Registry Report 2012. ASAIO J. 2013; 59:3:202210.
    [Google Scholar]

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