The Catalan health system has created a pioneering transfer program with pediatric ECMO (extracorporeal breathing equipment) that guarantees permanent assistance to children anywhere in the territory. The protocol is inspired by the case of Aisha, a girl born with severe respiratory problems who, on the first day of her life, went through three hospitals, in the midst of a complex deployment of professionals and technology, in order to survive.
Sleeping in her mother's arms, with a pacifier in her mouth, oblivious to the presentations of the authorities and professionals, unperturbed by the applause. This is how little Aixà attended the presentation of a pioneering assistance and transfer program with pediatric ECMO that will be officially activated in Catalonia on June 1
The protocol is for extremely serious cases. Normally, patients are transferred early to highly specialized hospitals that can apply the ECMO technique to children. But sometimes there is no option, and in Catalonia there have been 12 transfers of pediatric patients with ECMO in the last ten years, most of children and pre-adolescents from other autonomous communities that lack this possibility.
It is a service that is only offered by the Vall d'Hebron and Sant Joan de Déu hospitals, in Barcelona; on October 12, in Madrid, and the University of Malaga. Until now, these highly complex transfers depended on hospital centers, a predominant model in the world. Now, in Catalonia, they will depend on the emergency system, which will be permanently available anywhere.
"This is a pioneering program in the State that was born from a varied experience, the most recent being that of Aisha", explained the Minister of Health, Manel Balcells. This is the first pediatric transfer on ECMO performed this year in Catalonia and the only case, historically, of a patient with less than a day of life.
Aisha was born on March 4 at the Santa Tecla hospital, in Tarragona, with respiratory complications for which she was referred to the Joan XXIII hospital. She had aspirated meconium (his feces from her) during childbirth and amniotic fluid had entered her lungs. "It is probably the most serious pathology that a baby can have at birth," said Mar Albújar, head of Pediatric Critics at the center.
The girl's central nervous system was not affected, but the respiratory level did not improve. At nine o'clock at night, when she had 15 hours to live, she was activated, as a last resort, to transfer her to the Vall d'Hebron hospital. An ultra-specialized team of 12 professionals including doctors, nurses and emergency technicians participated in the operation, who traveled to Tarragona to apply extracorporeal membrane oxygenation therapy.
After ten days connected to ECMO in the Vall d'Hebron ICU and almost two months of admission, the girl has recovered. Her mother, Radya Bakkari, has been emotionally grateful for the intervention of the medical device, with Aisha in her arms, in the middle of a deep sleep.
Joan Balcells, director of the Vall d'Hebron Pediatric ECMO program, highlighted the complexity of this technique: "It allows the function of the heart and/or lungs of patients to be replaced. We have to take blood out of the body, add oxygen to it, remove carbon dioxide from it, and return it to the body. Between the two centers set up in Catalonia (Vall d'Hebron and Sant Joan de Déu) we treat between 40 and 50 cases a year."
