Extracorporeal Membrane Oxygenation (ECMO) in Sheba Medical Center: Trends, Outcomes, and Indications.

Introduction:
Utilization of extracorporeal membrane oxygenation (ECMO) is expanding in the last years. We report the experience in a cohort of consecutive patients receiving ECMO in our hospital.

Methods:
We conducted a retrospective cohort analysis of 44 patients aged ≥18 years that underwent ECMO in large tertiary center 01.01.2014 to 15.12.2016. Patients were hospitalized in Cardiac Surgery ICU – 34 patients, General ICU – 6 patients and in the Catheterization Laboratory – 4 patients.

Results:
During 3-years study period, ECMO utilization increased from 7 patients 2014 to 20 patients in 2014. Indications for ECMO were severe respiratory failure (8 patients), post-cardiotomy syndrome (10 patients), cardiogenic shock, both ischemic and non-ischemic origin (18 patients), high-risk ventricular tachycardia ablation (4 patients) and other indications (4 patients). Mean ECMO time was 5.8±4.7 days. We use veno-venous connection to ECMO – 6 patients and veno-arterial – 38 patients. In the overall cohort, decanulation rate was 56% and 30-day mortality was 62.2%. Survival at 1 year was 38.4%.

Conclusion:
Outcomes of ECMO associated with high 30-days and 1-year mortality. Despite this, ECMO should be used in the cohort of the high risk cardiac patients and patents with severe ARDS and respiratory failure.