Objectives
To benchmark mortality of cardiac Extra-Corporeal Membrane Oxygenation (ECMO) in our institution, against the Extracorporeal Life Support Organisation (ELSO) Registry’s survival data.

Methods
Prospective audit data from all ECMO cases January 2004 to November 2008 were reviewed for age, weight, operation, indication for ECMO, and duration of mechanical support.
Primary outcome measure was survival to hospital discharge. This was compared to ECLS Registry survival statistics for neonatal cardiac ECLS (38%) and paediatric cardiac ECLS survival (44%) (ELSO Registry, 2006).


Results
20 patients underwent ECMO, representing 1.6% of all cardiopulmonary bypass cases undertaken during this period. 10 patients (50%) were neonates (6% of neonatal bypass cases). Median age was 36.5 days (range 4 days-10 years) with a neonatal mean body weight of 3.25 kg (range 2.4-4.1 kg).
Median duration of support was 4 days (range 3-7). The main diagnostic groups requiring ECMO support were Transposition of Great Arteries, Aortic Stenosis, Hypoplastic Left Heart Syndrome and Tetralogy of Fallot.
ECMO was instituted in theatre in 15 cases, and on PICU in 5 cases (3 cardiac arrest, 2 persistent low cardiac output state).
Two patients were transferred on ECMO support for ongoing care in ECMO centres.
There were one PICU death, two hospital deaths, and 17 patients (85%) surviving to hospital discharge (90% neonatal and 80% pediatric survival).

Conclusion
Despite the infrequent use of cardiac ECMO in our institution, survival compares favourably with ELSO registry survival data. However, small patient numbers, patient selection and short ECLS runs may bias our results.