Treatment of acute respiratory distress with ECMO Experience of the Pneumology Department of Trieste [Terapia dell'insufficienza respiratoria acuta mediante ECMO Esperienza della Pneumologia di Trieste].

Extracorporeal membrane oxygenation (ECMO) is an extracorporeal technique of which provides respiratory support oxygen to patients with severe lung disease which no longer responds to conventional intensive therapy, including invasive mechanical ventilation. ECMO in Italy is usually located in general Intensive Care Units (ICUs), and patients are not managed by the specialist Pneumologists. We show the first year results of the experience of the University Hospital of Trieste where ECMO is located in the Cardiac Surgery ICU and there is a multidisciplinary team which includes Pneumologists cooperating to the management of the patients treated with ECMO due to pulmonary diseases or severe pulmonary hypertension. From January 2010, following the pandemic influenza H1N1, were treated 8 patients for refractory acute respiratory failure (2 women and 6 men, 35 years old on average, 3 with H1N1 infection, 2 with cystic fibrosis, 1 with Wegener's disease, 1 with ARDS and 1 with pulmonary hypertension), with severely lungs disease no longer responsive to conventional intensive therapy. Out of these 8 patients in ECMO 4 died, 3 were discharged from hospital and 1 proceeded to successfully pulmonary transplantation. In Italy and in Europe, it is uncommon to find a multidisciplinary team including Pneumologist to treat patients using ECMO due to severely lungs disease. The Pneumology experience of Trieste was made possible thanks to the expertise reached managing patients with severe acute hypoxemic respiratory failure in the Intensive Respiratory Care Unit.