1. ELSO Registry
2012

2. Original ECMO Registry Report 1988

3. Original Registry Report 1988
Neonatal ECMO Outcomes

4. Original Registry Report 1988

5. Original Registry Report
Calibrating the Learning Curve
Improvement up to 30 cases

7. ELSO Centers, 2012 T

8. Euro-ELSO Meeting

9. Overall Patient Outcomes
ELSO Registry July 2012

10. Runs by Year
ELSO Registry July 2012

11. Neonatal Respiratory Cases
ELSO Registry July 2012

12. Neonatal Survival by Diagnosis and Year
ELSO Registry July 2012

13. Pediatric Survival by Diagnosis and Year
ELSO Registry July 2012

14. Adult Survival by Diagnosis and Year
ELSO Registry July 2012

15. Initial Mode of Adult Respiratory Support
ELSO Registry July 2012

16. Cardiac Survival by Diagnosis and Year Under 16 years
ELSO Registry July 2012

17. Cardiac Survival by Diagnosis and Year 16 years old and over
ELSO Registry July 2012

18. ELSO Registry Applications
Case questions
Overall and specific reports
Document trends and progress
Identify ECMO centers
Epidemic management (H1N1)
Center specific, benchmark data
Center certification?

21. Benchmarking/Quality Assurance
Center Specific Complications International Summary Complications
Neurologic: Seizures: clinically determined 6
1.7% 2
33%
Neurologic: CNS infarction by US/CT 5
1.4% 1
20%
Neurologic: CNS hemorrhage by US/CT 11
3.0% 9%
Renal: Creatinine
140
38.7% 62
44%
Renal: Creatinine > 3.0 78
21.5% 28
36%
Renal: Dialysis required 63
17.4% 22
35%
Renal: Hemofiltration required 85
23.5% 33
39%
Total Registry Complications
Neurologic: Seizures: EEG determined 12
0.5% 6
50%
Neurologic: CNS infarction by US/CT 45
1.9% 9
20%
Neurologic: CNS hemorrhage by US/CT 91
3.8% 16
18%
Renal: Creatinine
468
19.5%
169
36%
Renal: Creatinine > 3.0
316
13.3%
123
39%
Renal: Dialysis required
393
16.3%
152
Renal: Hemofiltration required
545
22.7%
270

22. Registry Reports
> 200 papers and >20 chapters refer to ELSO Registry
> 40 Papers based on Registry Reviews
Registry Review : Examples
Adult Respiratory Failure:50 % overall survival
Brogan, ICM, 2009
Prematurity:IVH 6%, survival 53%<2 kg
Romiarek, J Peds Srg, 2004
Post Lung XP: 151 cases 42% survival
Fischer, JHLT, 2007
ELSO Registry January 2011

23. Registry Reports
Registry Reviews Mechanical Complications:15% cases, related to duration Fleming, PCCM, 2009 Infection: 12% incidence, related to duration Bizzaro, Ped CCM, 2011 Registry Review re Question: Vent days pre ECMO in peds, no effect until 14 d Domico,PedCCM, 2012 VV=VA in CDH Dimmit, JPeds Surg, 2001
ELSO Registry January 2011

24. Registry as a Control Database
Berlin Heart FDA qualifying trial: ECMO Bridge to Pediatric Heart Transplant: ELSO database, 773 Cases, 45% transplanted, 46% survival Almand, Circulaton, 2011 Berlin Heart Study Design, Case matching to ELSO Data, 48 cases EMO survival 60%, BH survival 92% Almand, Am Heart J, 2011 Berlin Heart FDA approved, 2011
ELSO Registry January 2011

25. Registry Prospective Studies
H1N1 Flu epidemic Brief case entry, essential data Brief Case outcome Continuous update during epidemic: Incidence, Age, vent days, obesity, pregnancy, ECLS days , outcome, Guidelines Neonatal follow up at age 18+ Engle, underway ECMOII vs ECMO I Registry committee, underway

26. Peter Rycus
Executive Administrator of ELSO Manging Editor of ELSO Publications Manager of the ELSO Registry ELSO Meeting coordinator ELSO Course coordinator Voice of ELSO

28. F:\ECMO\Slide_16.jpgF:\ECMO\Slide_16.jpg
Esperanza. The first neonatal ECMO survivor,
Bartlett and Gazzaniga 1975 28 28