Extracorporeal Membrane Oxygenation (ECMO) has evolved as an extension of extracorporeal circulation technology, a critical procedure that temporarily takes over the functions of the heart and lungs during cardiac surgeries or severe medical interventions. Globally recognized as the "Father of ECMO," Robert H. Bartlett successfully conducted the first neonatal ECMO in 1975. His pioneering efforts facilitated the adaptation of this technology for use beyond the operating room, enabling its application in intensive care settings. Today, ECMO is employed in cases of severe respiratory failure and cardiogenic shock where conventional treatment options have been exhausted. It is also utilized as a bridge to recovery, for organ transplantation, or as a precursor to implanting long-term ventricular assist devices.
Various studies have indicated that ECMO can significantly enhance survival rates for patients experiencing certain critical conditions compared to traditional treatments. Nevertheless, the implementation of ECMO is complex and associated with significant risks, including severe complications such as bleeding, thrombotic events, infections, and neurological issues. Successful ECMO intervention relies not only on the caliber of medical and technological resources but also on vigilant monitoring to timely address any arising complications. It is crucial to recognize that ECMO may not be suitable for all patients; careful patient selection and proactive management of potential risks and complications are essential to leverage the benefits of ECMO while minimizing adverse outcomes. Factors like advanced age, existing health conditions, and the severity of organ failure are critical in determining a patient’s eligibility for ECMO support.
Recent technological advancements in ECMO have markedly improved its safety and efficacy. Modern ECMO systems are designed with enhanced biocompatibility and include sophisticated components like hollow-fiber oxygenators and centrifugal pumps, which have reduced common complications such as hemolysis and thrombosis. The development and miniaturization of portable ECMO units have expanded their use beyond conventional ICU environments, facilitating their deployment in emergency scenarios and patient transport. These innovations have broadened the clinical applications of ECMO, making it a more adaptable and accessible option in diverse medical settings.
The Hospital Internacional de Colombia (HIC) is at the forefront of ECMO therapy. It was the pioneer in introducing ECMO in Colombia (since 2007) and the first institution in Latin America to earn the Center of Excellence designation from the Extracorporeal Life Support Organization (ELSO) in 2018, currently at platinum level. HIC has also conducted over 200 medical flights, both domestic and international, successfully transporting 37 ECMO patients in the past year alone. During the COVID-19 pandemic, this unit achieved a survival rate surpassing the benchmarks set by ELSO, a demonstration to its consistent excellence. These achievements underscore HIC's dedication to the highest standards of patient care and its significant role in advancing treatment options on both a national and international stage.
