Implementation and outcomes of a successful extracorporeal membrane oxygenation mobile retrieval service in chile during the sars-cov-2 pandemic

ECMO centers in Chile are concentrated in the capital, greatly limiting its access. On January 2021 a mobile ECMO service was implemented at Red Salud UC Christus in Santiago to serve Covid-19 patients across the country. Patients were triaged and allocated to receptor ECMO centers by a national coordinating committee. From January to May, we retrieved 51 patients from 31 centers across 10 of the 15 regions of the country and transferred them either to our own center (n=32, 62.7%), or to other 9 ECMO centers (n=19, 37.3%). Forty-six retrievals (90.2%) were for Covid-19, 3 (5,8%) for Hantavirus Cardiopulmonary Syndrome, 1 (2%) for cardiogenic shock and 1 (2%) for ARDS secondary to Loxoscelism. Retrievals were performed by a 4-member team, 31 (60.8%) in fixed wing aircraft and 20 (39.2%) by land. Patients were 37.3±11.75 years old and 44% (n=23) were female. Forty-seven (92.2%) patients were placed on VVECMO and 4 on VA-ECMO, 42 (82.4%) with femoro-jugular and 9 (17.6%) with femoro-femoral configuration. A Rotaflow® pump was used. All cannulations were percutaneous, except 2 patients with surgical cannulation for VA-ECMO. Complications included 1 jugular perforation and 1 cannula displacement, both resolved without major consequences. Among the 32 patients transferred to our center, ECMO duration was 4.1±6.9 days, 25 (80.6%) were successfully weaned off ECMO and 20 (64.5%) have been discharged alive. Five patients are still in hospital. This series describes a successful mobile ECMO program implemented in the middle of SARSCoV-2 pandemic by an experienced ECMO center in Chile.