Hospital Infantil SanVicente Fundación-ECMO Training Program

As part ofourcommitment toimprovingpediatriccongenital heart disease(CHD)treatmentinColombia,the LPR Foundationhostskey physiciansfrompartner hospitalstorotatewith thehighlyspecializedcardiovascularteams at Nicklaus Children’s Hospital(NCH).In September 2021,Dr. Sonia Morales, the Cardiovascular Surgeon from Hospital Infantil San VicenteFundación(HISVF)in Medellín(akey surgical referral center for the GlobalHealth Initiative), spent twoweeks workingintenselywith Dr. Redmond Burke,esteemedFounder and Director of theNCHCongenital Heart Institute and Dr. JuanBolívar, Pediatric Cardiologist and Director of theNCHPediatric Intensive Care Unit (also a fellow Colombian).Dr. Moralesreturned to Medellín toimplementmany of theadvanced cardiovascularsurgical techniques, practical lessons andquality careprotocols learnedat NCHand immediatelyinitiatedformal plans for increasingHISVF’s surgical complexity through advanced hemodynamic procedures, includingExtraCorporeal Membrane Oxygenation (ECMO).

Drs. Juan Bolívar, Sonia Morales and Redmond Burke

What is ECMO?

Extracorporeal Cardiac Membrane Oxygenation (ECMO) is a highly advanced and specialized procedure used in certain critical care situations for the management of severe and refractory cardiac or respiratory failure. In children, ECMO support is usually needed due to a combination of pulmonary dysfunction, pulmonary hypertension, and right ventricular dysfunction. The procedure itself involves a heart-lung machine that pumps blood from a patient’s lungs to an artificial lung outside the body that removes carbon dioxide and improves oxygenation before it is pumped back into the patient. The ECMO procedure allows for the child’s heart and lungs to rest and heal, improving patient outcomes. The provision of an ECMO service requires a group of dedicated specialists professionally trained in ICU POP management, mobilization, monitoring, bleeding risk, thrombosis, infection, and multi-organ failure.

ECMO International Certification Program

Upon her return to Medellín, Dr. Morales presented ECMO training to the hospital and the LPR Foundation as a prime opportunity to improve the level of cardiovascular surgical complexity at HISVF, which has proven to save the lives of children with heart and lung disease. The LPR Foundation funded all training costs for the entire integrated cardiovascular surgical team at HISVF to be internationally certified at CES University in Medellín in the theoretical and practical knowledge needed to establish an ECMO program. A total of nine HISVF medical staff were certified, including a cardiovascular surgeon, a cardiovascular anesthesiologist, a pediatric intensivist, a general pediatrician, perfusionists, as well as critical care nurses. The HISVF ECMO initiative involves developing a formal ECMO management protocol for pediatric critical congenital heart disease cases that develop potentially recoverable cardiogenic shock after corrective cardiac surgery.
Plans are also underway to have the HISVF perfusionist and intensivist rotate at NCH for additional training. NCH will continue to play a central role in the development and support of the HISVF ECMO program, with the full commitment and support from NCH, specifically Dr. Redmond Burke, and Dr. Keith Meyer, Medical Director of the NCH ECLS/ECMO and Apheresis Services, and a Critical Care physician. This program will help improve cardiac surgery complexity at HISVF, as well as preoperative and postoperative cardiovascular outcomes for all local pediatric CHD cases, including those referred through the LPR Foundation program from other regions of Colombia.

The HISVF Cardiovascular Team – ECMO Practical Training