UAB Cardiothoracic Surgery Annual Report 2015-16 UAB Medicine Cardiothoracic Surgery 2015/16 Annual | Page 23

EXTRACORPOREAL MEMBRANE OXYGENATION

The number of ECMO cases has increased dramatically from 10 patients in 2011 to 95 patients supported in
2015. UAB’s ECMO service has rapidly expanded, thanks to an increased focus on pulmonary ECMO support.
Our ECMO hospital survival rate increased from 30% in 2011 to 64% in 2015.

GENERAL CONDITIONS REQUIRING ECMO

TRANSPLANT & MECHANICAL CIRCULATORY SUPPORT

Extracorporeal membrane oxygenation (ECMO) is a temporary mechanical support system that facilitates heart
and lung function and is utilized extensively at UAB for patients with cardiac or respiratory failure. UAB has
maintained an active adult ECMO presence for the past 15 years and has one of the largest ECMO programs in
the United States. The program is a collaborative effort between cardiothoracic surgery, pulmonary medicine,
and advanced heart failure cardiology, and it requires a team of dedicated perfusionists and nurses.

• Veno-venous (VV) ECMO for pulmonary indications: flu, trauma, other respiratory failure, bridge to
or from lung transplant
• Veno-arterial (VA) ECMO for cardiovascular indications: post-cardiotomy, cardiogenic shock

ECMO Volumes and Percent Survival to Hospital Discharge: 2014 – 2015
Etiology: Respiratory
50

35

28

30
20

0

48

44

40

10

Etiology: Cardiology

9

15

73%
89%

49%

35%

Bridge to
Lung Transplant

Cardiogenic
Shock

67%
Flu

33%
Trauma

Other Respiratory
Failure

PostCardiotomy

n % Survival to Hospital Discharge

RATIONALE FOR AMBULATORY ECMO:
• Upright patients who are ambulatory and socially interactive provide the most effective vehicle for clinical
recovery or subsequent bridge to transplant.
• No lung disease or pulmonary injury benefits from paralysis, sedation, and intubation with non-physiological
positive pressure ventilation.

www.uabmedicine.org

21