Pediatric Extra Corporeal Membrane Oxygenation Practices and Challenges in Kingdom of Saudi Arabia and Gulf Cooperation Council Countries

Author(s):

Nada A. AlJassim, Nooralhuda A. AlHadab*, Nabeel Almashraqi and Mohamed Salim Kabbani

Introduction: Extracorporeal Membrane Oxygenation (ECMO) is a vital rescue therapy for patients experiencing refractory heart or respiratory failure after conventional intervention failure. Establishing a new ECMO program, particularly for neonates and children, has challenges in logistics or operation. Furthermore, maintaining a standardized ECMO program add more complexity.

Methods: A cross-sectional survey was distributed to health care professional in Saudi Arabia and the GCC to describe the pediatric ECMO experience, practices and challenges for potential expansion.

Results: A total of 254 responses were collected, 82% from Saudi Arabia. In these, 56% have ECMO service at their centers. Majority are working in Pediatric Intensive Care Units (PICUs), with >300 admissions per year, treating respiratory failure cases as top diagnosis. ECMO experience and practice was variable among respondents as well as in ECMO deployment and management with main findings: (1) Nearly 60% of respondents have no experience or limited exposure to ECMO during their training; (2) Pediatric ECMO is primarily used for cardiac cases in the region via central cannulation, with limited respiratory use reported and (3) Challenges in establishing ECMO include a lack of logistics, manpower and system support.

Conclusion: Despite the life saving role of ECMO in pediatrics, its availability is limited service and with many challenges. Enhanced pediatric ECMO training and system support are crucial for successful program initiation and development.