Initial Egyptian extracorporeal membrane oxygenation experience

We describe our initial experience at the first ECMO center in Egypt. Methods Our adult ECMO program started January 2014. Since then we supported eleven patients on ECMO in respiratory failure patients indicated according to ELSO guidelines and one case of ECMO CPR. Respiratory failure patients were subjected to VV ECMO when lung injury score (LIS) was above 3 and PaO2/fIO2 <100 on protective lung strategy mechanical ventilation according to ARDS net protocol and or severe hypercapnoea with pH<7.2 with trial of prone positioning in indicated cases. Percutaneous cannulation was done in all patients using single lumen cannulae, additional cannula was added when needed. Cardiohelp (Maquet, Germany) and Rotaflow (Maquet, Germany) ECMO consoles were used with centrifugal pump. ECMO circuits PLS for Rotaflow and HLS for cardiohelp were changed when indicated. The ECMO CPR patient was a primary PCI for acute inferior STEMI complicated by left main occlusion, VA ECMO instituted in the cathlab after 20min of CPR. Percutaneous (and or surgical) tracheostomy was done after 14days of mechanical ventilation. Results A total of twelve patients received ECMO between January 2014 and June 2015. The mean age was 35.9years (range 13–65years), 8 males. VV ECMO was done in 10 patients, and VA ECMO in 2 patients. Out of ten patients of VV ECMO, one had H1N1 pneumonia, one had advanced vasculitic lung, four had bacterial pneumonia, two traumatic lung contusions and one organop...
Source: The Egyptian Journal of Critical Care Medicine - Category: Intensive Care Source Type: research