[ad_1]
The São José Hospital, in Lisbon, received four patients with covid-19 from the North region who need ECMO, an essential extracorporeal circulation device for the treatment of critical patients and that allows to temporarily replace the function of the heart and lungs. “The Central Lisbon Hospital Center (CHLC) [onde está integrado o Hospital São José], is carrying out rescues with ECMO (intensive care) of patients with covid-19 in the North, ”he says, in a note sent to Lusa.
On Friday patients were received from the hospitals of Penafiel, Pedro Hispano, in Matosinhos and Bragança, and this Saturday a patient from the Guimarães Hospital. “We expect the lockdown to reduce the pressure on the NHS in the coming days. [Serviço Nacional de Saúde]”, Highlights the CHLC, adding that” patient management works fully between units. “
The Hospital and University Center of S. João, in Porto, the hospitals of Santa Maria and S. José, both in Lisbon, are reference centers for ECMO. This technique was introduced in the country ten years ago due to influenza A.
OR Observer He said that São João has exhausted its capacity, so these patients were transferred to hospitals in the Lisbon region, information that was confirmed to the PUBLIC by the hospital’s communication office.
TO Observer, the coordinator of the ECMO São João Reference Center says that the hospital has the capacity to have 15 patients in these circuits and that, currently, 11 of these 15 are covid-19 patients. Roberto Roncon says that there were “a significant number of patients who were referred from hospitals in the north of the country,” to which the hospital was unable to respond.
In an interview with Lusa last week, Roberto Roncon had explained that this “type of cutting edge technology”, which was seen as a “cutting edge rescue technique”, began to be applied “earlier” in patients who are in intensive care .
“In a pandemic, it is an illusion to think that we have the ideal resources. We never will. If you ask me if I have the ideal resources for the ECMO program [Oxigenação por Membrana Extracorporal]no. But neither do we have it for intensive care, nor for emergency (…). We cannot have more demand than supply. Telling the truth is a way of holding people accountable, ”says the São João Roberto Roncon Hospital specialist.
But it is common to have patient transfers since the system works in a network. Hospital São João has already “rescued” patients from the Azores referred to ECMO and Lisbon, where both Hospital São José and Santa Maria have an ECMO response, they have already “come from the North”.
In the interview, the coordinator is clear and direct about the response capacity of the hospitals: “To say that it is easy and that we will respond to all requests is to tell the story of the old woman. We are in a context of pandemic ”.
The time a patient needs this technique is “highly variable, but in covid-19 it is high” and this, Roberto Roncon admits, “is also one of the current concern factors” because “it is rare that the patient needs less than two, three weeks of ECMO and there are cases of one or two months ”. “In terms of resource consumption, this is brutal,” he admits.
Flexibility and networking
According to Roberto Roncon, to guarantee a response, the solution lies in the network and not in generalization, especially because “the countries that tried to generalize ECMO had terrible results.” The specialist says that there is some flexibility in the management of this type of care.
“People with experience lower the rate of complications. It makes sense to concentrate teams and experience (…). But is a seriously ill patient with covid-19 going to die because he is in a hospital that does not have ECMO? Wrong idea. There has been miniaturization for about 10 years. [máquinas compactas e portáveis] extracorporeal circuits. You can pick up a patient from another hospital and take him to an ECMO center, ”he describes.
That is what happens in Portugal. Two weeks ago, when the Matosinhos Hospital referred a patient to ECMO, São José “came” to pick her up, but the next day São João would have more free time, says the doctor.
