Qatar Medical Journal - 1 - Extracorporeal Life Support Organisation of the South and West Asia Chapter 2017 Conference Proceedings, February 2017

Simulation training is increasingly being used to provide clinical care providers with experience and competence in high-risk procedures that occur infrequently. Implementation of standardized extracorporeal life support (ECLS) simulation training improves multidisciplinary team processes and increases efficiency of establishing ECLS. The initiation of ECLS is a highly complex process that requires technical proficiency of the surgeon Read More

Background: Extracorporeal membrane oxygenation (ECMO) is a high-complexity life-saving procedure riddled with mechanical complications that can place the patient in a critical state where fast and coordinated actions are required to avoid mortality. Thus, patients on ECMO are supervised round the clock by highly trained nurses and perfusionists. Currently, ECMO training programs include patient emergency simulations performed with di Read More

Background: In medical simulation and training, blood is used to exhibit its different behaviors in context. In some cases, blood color differential is an imperative visual effect to ensure high-fidelity training and practical understanding. High simulation realism is usually achieved by using animal or artificial blood (which mimics some biological features of blood), which has high cost, requires disposable equipment such as oxygenators, an Read More

Background: Transport of critically ill patients especially on extracorporeal membrane oxygenation (ECMO) is a real challenge. In India, more than 98% of cases requiring transfer are transported by road and less than 2% of cases are transported by air due to costs involved. As an institutional policy, and considering the safety and cost effectiveness, we have decided to develop mobile teams who can go to the patients, cannulate them, and sta Read More

Background: The mission of the King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, is to provide safe and effective care to patients. KFSH&RC is a 985-bed hospital that started its ECMO program in 2004. Based on the ELSO guidelines, KFSH&RC invested in establishing a successful ECMO program by upgrading the logistic, team composition, quality, and educational structure in the organization.1Methods: Th Read More

Background: Although there have been many developments related to specific strategies for treating patients after poisoning exposure, the mainstay of therapy remains symptomatic and supportive care. Objectives: To highlight different techniques of ECMO, indications, contraindications, and some case reports of its use in patients with poisoning. Methods: PubMed and the Cochrane database were searched using the terms “extracorporeal m Read More

Background: Streptococcal toxic shock syndrome (STSS) is a life-threatening illness associated with invasive or non-invasive group A streptococcal (GAS) infection with rapid progression and a high mortality rate.1 There are limited data on the use of extracorporeal membrane oxygenation (ECMO) in toxic shock syndrome (TSS) with few case reports in adults with TSS-induced cardiac dysfunction2,3 and a pediatric series of severe group A strept Read More

Background: 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. Methods: After obtaining an DSREC (Dubai Scientific Research Ethics Committee) review and exemption, we collected the clinical data of pati Read More

Introduction: Bleeding is the most frequent complication in patients receiving veno-arterial or veno-venous extracorporeal membrane oxygenation (ECMO).1,2 Recombinant activated factor VII (rFVIIa) has been used in these patients with conflicting results. We describe our experience in pediatric patients on ECMO who received rFVIIa for refractory bleeding in whom conventional management was not successful. This conventional man Read More

Background: ECMO has been successfully used to support patients with trauma-induced respiratory failure. Here, we present the successful application of ECMO in a patient with life-threatening polytrauma following a road traffic accident complicated by severe acute respiratory failure.1Methods: This is a retrospective case report, and approval for presentation has been obtained from the department and can be submitted upon request. The Read More

Background: Intensive care patients are at high risk of increased mortality and morbidity and longer hospital stay secondary to prolonged immobility.1Methods: Early mobilization and therapeutic exercises reduce delirium and days on mechanical ventilation, shorten ICU and hospital stay, improve physical function, and reduce healthcare costs.2,3 Mobilization and exercise can be safely implemented for patients receiving mech Read More

Background: Awake extracorporeal membrane oxygenation (ECMO) in conscious, extubated patients has been used successfully in adults and children, primarily as a bridge to lung or heart–lung transplantation and recovery from refractory cardiogenic shock.1,2 However, this strategy has been reported only as an exceptional measure in neonatal patients. We present a case of neonatal respiratory failure where an infant was extubated while Read More

Background: Extracorporeal membrane oxygenation (ECMO) has evolved as a treatment option for patients having rev ersible severe respiratory failure who are deter iorating on conventional ventilation.1,2 We describe our experience with a patient who received ECMO for refractory hypoxemic respiratory failure due to community-acquired pneumonia associated with systemic lupus erythematosus (SLE). Methods: This is a retrospecti Read More

Background: One of the Millennium Development Goals is to reduce childhood mortality by two-thirds by 2015 (www.un.org/millenniumgoals). This study was conducted to identify the clinical profile and pattern of disease, and to find out the commonest cause of mortality and morbidity of neonatal ICU patients in a Nepali teaching hospital. Methods: A retrospective study was conducted at a grade IIIA NICU in the Neonatal Intensive Care Unit Read More

The utilization of extracorporeal membrane oxygenation (ECMO) to support patients with respiratory and/or cardiac failure continues to increase annually, with growth primarily in the adult population.1 The life-saving therapy requires a multidisciplinary team to deliver the highly technical treatment with clinical competency in three areas: cognitive knowledge, technical skills, and behavioral skills. The use of traditional methods Read More

This is a case presentation of a 16-year-old male patient who arrived in South Africa after a trip to Hong Kong. He had been on a sports tour. Previously, he had been healthy with no past medical history of note. Days prior to leaving Hong Kong, he had contracted a flu-like illness. On arrival at O.R. Tambo International Airport (in South Africa), he was showing signs and symptoms of deterioration in condition, including fever, coughing and confus Read More

Dr Robert Bartlett is the pioneer surgeon credited for moving extracorporeal life support (ECLS) from the operating room to the intensive care unit (ICU), where the therapy has given hope for survival to thousands of neonates, children, and adults with respiratory and/or cardiac failure. Dr Bartlett describes the ECMO timeline as ECMO 1 (1990–2008) and ECMO 2 (2008–present).1 The first phase of ECMO utilized individual components, d Read More

Introduction: At the start of every new extracorporeal membrane oxygenation (ECMO) center, safe and effective use of ECMO therapy requires unique institutional resources and strategies to optimize patient care and outcome. This is a report of the initial experience at the first ECMO center in Lebanon; the course of five patients is described, focusing on the monitoring considerations.1–4 Lessons learnt help improve patient ECMO care, safety Read More

Background: “ECMO for Greater Poland” is a program being developed to serve the 3.5 million inhabitants of the Greater Poland region (Wielkopolska) based on an approach already implemented in the USA1 or Qatar.2,3Method: The program is complex and takes full advantage of the ECMO perfusion therapy opportunities to save the life of patients in the Greater Poland region. The main implementation areas are: – treatment of patients wi Read More

Background: Poland is setting up its first regional ECMO program and relies heavily on the use of simulation in testing processes and training clinicians.1 As ECMO is a complex and expensive procedure, we developed an advanced ECMO simulator for high-fidelity medical simulation training.2–6 It can be used to modify any type of full-body patient simulator and allows for the creation of an unlimited number of scenarios. Methods: The system i Read More