ECMO in Spain: present and future

Extracorporeal membrane oxygenation (ECMO) support has become established in recent years as one of the most advanced therapies for the treatment of critically ill patients with severe respiratory or cardiac failure. However, its growing implementation across hospitals in Spain is creating new organisational challenges for the healthcare system.

This was one of the central themes discussed during the 1st ECMO Update Conference in Spain. Held on 26 February at the Ramón y Cajal University Hospital in Madrid and organised by the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), the event brought together national and international specialists to analyse the current situation of extracorporeal support in Spain and to share clinical, organisational and training experiences.

A highly complex therapy on the rise

ECMO is an extracorporeal life support technique that temporarily replaces the function of the heart and/or lungs through an external circuit that oxygenates the blood and returns it to the body. It is used in critical situations such as severe respiratory failure, cardiogenic shock or refractory cardiac arrest, when conventional treatments are no longer sufficient.

In Spain, the development of specialised intensive care medicine programmes focused on ECMO has progressed significantly. This growth, led by multidisciplinary teams, has made it possible to expand clinical indications and dramatically improve the care provided to critically ill patients.

The current challenge: organising the healthcare system

During the conference, several specialists highlighted that the expansion of ECMO programmes has not always been accompanied by coordinated regional planning. According to the experts, the current organisation varies between Spain’s autonomous communities, creating differences in coverage, coordination between centres and critical care patient transport models.

In response to this situation, professionals from SEMICYUC stressed the need to move towards a structured national strategy for adult ECMO support, with the aim of ensuring:

• Equal access to therapy throughout the country.
• Consistency in healthcare quality standards.
• Sustainability of the public healthcare system.

International models show that the creation of reference centres, clearly defined referral networks and specialised transport systems helps to improve patient safety and the efficiency of clinical outcomes.

Training, research and care coordination

Another key topic discussed was the importance of strengthening national registries, outcome auditing and specialised ECMO training programmes. Collaboration between hospitals, scientific societies and healthcare authorities is considered essential for consolidating this advanced therapy.

Spain has highly qualified professionals in intensive care. The current challenge lies in improving organisational coordination in order to guarantee equal access and maintain high standards of quality in the management of critically ill patients.

Source: Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)