Experiencia con soporte de oxigenación con membrana extracorpórea en América Latina entre 2016 y 2020

Abstract

Objective

To document the experience with ECMO therapy in healthcare institutions across Latin America between 2016 and 2020.

Design

Cross-sectional study.

Setting

Private and public health institutions from 7 countries.

Participants

ECMO intensive care units.

Interventions

None.

Main variables of interest

General characteristics of the center (country, ELSO center, year of first cannulation, public or private network, ECMO devices available, mobile ECMO), professional category (nurses, physicians, specialists and other professionals), nurse-to-patient ratio, interventions applied (support indications, scores, mechanical ventilation at ECMO commencement, anticoagulation and hemolysis, circuit monitoring and patient perfusion, antibiotic prophylaxis), and patient outcomes (complications and survival) in ECMO centers.

Results

Thirteen ECMO units were included. These units reported 133 consoles and 1,629 ECMO cannulations. Of these, 1,018 corresponded to adult patients, 468 to pediatric patients, and 143 to newborn infants. A total of 310 medical specialists were involved in ECMO care, of whom 70.3% had received ECMO training. The nurse-to-patient ratio was 1:1 in most centers (76.9%, n = 10). Amongst adult patients, the most common indication for initiating ECMO support was refractory hypoxemia, whereas in pediatric patients, it was a post-cardiotomy shock. The mean overall survival rate of the patients at the time of decannulation was 55.7% (95%CI: 53.0-58.3).

Conclusions

The ICUs with ECMO in Latin America participating in this study have demonstrated operational capabilities enabling them to achieve outcomes comparable to those of other ECMO units across the world.