ECMO: Improving our results by chasing the rabbits

Abstract

As Marcelo Giugale published in the Financial Times, Latin America, on the whole, has not excelled at innovation - doing the same things in a new and better way or at doing new things. It has been slow to acquire, adopt and adapt technologies by this time available in other places[1]. Although extracorporeal membrane oxygenation (ECMO) is not a new technology, its use in Latin America is not widespread as needed. Furthermore, we still have a number centers doing ECMO, not reporting their cases, lacking a structured training program and not registered with the extracorporeal life support organization (ELSO). With this scenario, and accepting that ECMO is the first step in any circulatory support program, it is difficult to anticipate the incorporation of new and more complex devices as the technologically advanced world is currently doing. However, the good news is that with the support of experts from USA, Europe and Canada the results in Latin America ELSO'S centers are improving by following its guidelines for training, and using a standard educational process. There is no doubt that we can learn a great deal from the high velocity organizations - the rabbits - whom everyone chases but never catches, that manage to stay ahead because of their endurance, responsiveness, and their velocity in self-correction[2].

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

“…It is well known that there is a considerable gap between excellence medical centers accomplishments and Latin America follow through [ 22 ] . Nevertheless, as in Brazil, some isolated efforts in Argentina and Colombia are noticed in this direction leading to promising results, as the recently published Garrahan's group initial experience with MCS [ 23 ] .…”

Pediatric Mechanical Circulatory Support Systems in Latin America

“…Since the first successful utilization of ECMO in 1975 more than 69 000 patients have been supported worldwide, but less than 1% of the Extracorporeal Life Support Organization (ELSO) registry patients are from LATAM countries. In 2012, the Latin‐American ELSO's chapter was founded in order to enhance the use of ECMO and its credibility in the region, through the helpful guidelines and expertise of the organization . Following ELSO guidelines for training, centers from Chile, Colombia, and Brazil started a standard education process, with the support of experts from the USA, Europe, and Canada.…”