032OVERALL FIVE-YEAR RESULTS OF AN EXTRACORPOREAL MEMBRANE OXYGENATION PROGRAMME IN A UNIVERSITY HOSPITAL

Objectives: To analyse the results of circulatory and respiratory support by extracorporeal membrane oxygenation (ECMO) in our establishment. Methods: ECMO was established in 194 patients between January 2006 and December 2012 and the results analysed. Mean patient age was 53.2 years, the majority being male (n = 125, 68.3%). ECMO was inserted in the operating room in 102 patients, with 81 inserted in the Intensive Care Unit. Indications were: cardiogenic shock (n = 47, 25.7%), post-cardiotomy (n = 40, 21.9%), post-transplant (n = 22, 12%), adult respiratory distress syndrome (n = 46, 25.1%), drug poisoning (n = 7, 3.8%), and refractory cardiac arrest (n = 5, 2.7%). One hundred and thirty five were veno-arterial ECMO, 48 veno-venous, with 15 intrathoracic ECMO and 168 peripheral. Mean IGS 2 score was 48.7, with 28 ECMO insertions (15.6%) performed during external cardiac massage. Twenty-six patients (14.8%) already had intra-aortic balloon pump at the time of ECMO insertion. Results: Survival to ECMO explantation was 60.7% (n = 111) and survival at six months was 47.5% (n = 87), with no difference between the ECMO type. Twenty-one of the 28 patients (75%) who had ECMO insertion during cardiac massage did not survive. For patients older than 65 years, the mortality was 72.3% (n = 34). Median length of circulatory support was 7.4 days and mean length of ventilatory support 13.3 days. Nine patients (5.1%) had ischaemic limb complications. Transfusion of red blood cells, platelets, and fresh frozen plasma was necessary in 145 patients (85.8%), 97 patients (58.8%) and 87 patients (52.7%) respectively. Conclusions: ECMO produced a satisfying survival of 47.5% at six months in this cohort of high-risk patients. Implantation during external cardiac massage or in patients older than 65 years resulted in a poor prognosis.