Dr. Jordi Riera, director of the adult ECMO program at Vall d'Hebron University Hospital and principal investigator of the Shock, Organ Dysfunction and Resuscitation research group at Vall d'Hebron Research Institute (VHIR), is one of the authors who collaborated in a paper that analyzed the experience in the use of ECMO during the COVID-19 pandemic. The study has been published in the prestigious journal Intensive Care Medicine.

Vall d'Hebron has been one of the world's leading centers in the use of extracorporeal membrane oxygenation (ECMO) in patients with COVID-19. So far, 121 critically ill patients have received support with this technique, with a survival rate of 70%, higher than the international average. These are patients in an extreme situation, with no response to the usual treatments. The team usually travels to the center where the patient is admitted to initiate this extracorporeal rescue therapy. The blood is oxygenated outside the patient's body and the inflamed lungs can be left at rest.

In research, at the beginning of the health crisis, Vall d'Hebron led the ECMOVIBER study, created and coordinated by Dr. Riera, in which 24 centers in the Iberian Peninsula participated with the inclusion of more than 300 patients. The analysis, published in two leading scientific journals, identified important factors related to survival, a very important finding in the therapy of patients with extracorporeal life support.

This new paper presents the consensus among 16 experts from around the world analyzing the impact of the ECMO treatment experience during the COVID-19 pandemic to provide conclusions for the future. Among the data presented is the evidence provided by the ECMOVIBER study. The authors highlight that it is important to take many aspects into account to ensure success. "ECMO is a complex technique, where the chances of success are related to many details that we have to control meticulously. Especially during a context of uncertainty, such as the pandemic, collaboration between centers is essential in order to learn from each other", says Dr. Jordi Riera.

Thus, the moment at which ECMO is applied, the configuration of cannulation, the management of patient sedation... are important factors. It is also essential to have established criteria for indication and contraindication: advanced age, chronic lung disease or the presence of other comorbidities can be factors that contraindicate the therapy. "Future studies will have to focus on adjusting each of these aspects to improve patient care and survival. The research process should never stop, in the spirit of continuous improvement and potential expansion of indications", confirms Dr. Riera.

ECMO at Vall d’Hebron

Vall d'Hebron is a leading center in ECMO from the point of view of care due to the high number of cases treated; of research due to the large volume of articles and projects; of teaching, to promote the training of a large number of professionals; and of innovation, with the creation of the Hybrids-Vita high-fidelity simulator, developed by Dr. Riera in collaboration with biomedical engineers.

Patient care at Vall d'Hebron is characterized by a very careful assistance, by the high level of training and experience of the team, and by the adherence to the recommendations of the ELSO, the international reference society in ECMO of which Dr. Jordi Riera is part as a member of the scientific supervisory committee.