Experience achieved after implementation of the Veno-Venous ExtraCorporeal Membrane Oxygenation(ECMO) retrieval program in the region of Madrid (Spain). Hospital Universitario 12 de Octubre

Objectives: The objetive of this study is to describe the cases trasferred to an ECMO referral;s centre (Hospital Universitario 12 de Octubre, Madrid (Spain)), to investigate characteristics before ECMO and while the patient was on ECMO, to analyse the presence or not of complications secondary to transfer and cannulation and finally to analyse the ICU outcome. Method(s): This is a Prospective study done from November 1st, 2020 to December 31st, 2022. The cases were accepted either for emergency ECMO cannulation in the hospital of origin and retrieval or for conventional transfer. We analysed basic decriptive variables such as male proportion, age, IMC and etiology of ARDS and variables before ECMO such as prone position, duration of non-invasive ventilation, invasive ventilation and ICU leght of stay before ECMO. We recorded ELSO, SOFA and APACHE Severity Scores. We also analysed several variables on ECMO: if prone position on ECMO was done, median days of ECMO and succesfull weaning from ECMO. We also recorded whether there were complications or not in the transfer and cannulation. Finally ICU survival was examined. Result(s): 31 cases were accepted. 22 (71 %) were male. 29 cases were accepted for emergency ECMO cannulation. Median age was 47 years and IMC 31.1. The etiology of SDRA was COVID 19 infection in 23 cases (74% cases). Lenght of non invasive and invasive ventilation before ECMO were 4 days and 3 days respectively and lenght of ICU admission before ECMO was 2 days. Prone position was 1 day and 2 prone sessions were done before ECMO. Severity scores: APACHE 10 , SOFA 4 , ELSO 3 . On ECMO Prone position was done on 15 cases(48.4%) . Median days on ECMO were 13.5 days. Succesfull weaning from ECMO were achieved on 20 cases(61%), 2 cases remain on ECMO. No complications were seen on transfer or cannulation. ICU Survivors were 16(51.6%). Conclusion(s): After 2 years of experience on ECMO retrieval in the region of Madrid ECMO availability was achieved. Our results are similar than ELSO mortality.

Comparing Rates of Change in SARS-CoV-2 Wastewater Load and Clinical Cases in 19 Sewersheds Across Four Major Metropolitan Areas in the United States

There is no standard approach to interoperate the during the pandemic. We tested several data processing approaches on wastewater surveillance data sets generated from 19 sewersheds across four major metropolitan areas in the United States from May 2020 through October 2021. First, we explored the effect of different data processing techniques on the correlation between SARS-CoV-2 wastewater RNA load and clinical case counts and found that locally weighted smoothing (LOESS) smoothing applied to multivariate imputation by chain equations (MICE)-imputed wastewater viral load led to the strongest correlations in 16 out of 19 sewersheds (84%). Next, we calculated the rate of change (RC) in wastewater viral load and in clinical cases and found that imputing missing viral load data on a 28-day window produced the strongest correlation (Spearman's rho = 0.63). Furthermore, we determined an average sensitivity threshold of 2.4 new COVID-19 cases per day resulted in a significant RC in wastewater, but sensitivity varied with the laboratory method used. Our retrospective analysis using RC highlighted certain methodological insights, reduced site-specific impacts, and estimated a wastewater sensitivity threshold-supporting the use of relative, rather than absolute, measures of SARS-CoV-2 wastewater data for more interoperable data sets.

COVID-19 AND COLORECTAL ONCOLOGICAL SURGERY. EXPERIENCE IN A HIGH COMPLEXITY UNIVERSITY HOSPITAL

Purpose/Background: Perioperative COVID-19 infection is associated with an increase in morbidity and mortality, in addition to the consequences on surgical pathologies due to delays in diagnosis and treatment. Hypothesis/Aim: The aim of this study it is to describe and evaluate the effects of the pandemic on patients undergoing colorectal cancer surgery in the UC-Christus Healthcare Network. Methods/Interventions: A retrospective observational cross-sectional cohort study was made. It was based on the review of the admissions and surgical protocols of patients operated due to colon and rectal cancer diagnosis between 03/18/2019 - 03/17/2021 in the UC-Christus Healthcare Network. Patients with incomplete records and follow-ups, recurrences, or endoscopic treatments were excluded. The results of patients who were operated before the sanitary restrictions were compared with those who were operated afterwards (03/18/2020). The variables of sex, age, date of surgery, procedure, approach, tumor location, TNM, biopsy, pathological stage, presence of neoadjuvant and/or adjuvant, cause of mortality, emergency admission, and ostomy requirement were recorded in a database. The descriptive and analytic statistics of the results were analyzed using the Microsoft SPSS-Statistics21 program. Proportions were compared with the Chi2 test and Fisher's exact test in variables whose frequency was less than 5. Results/Outcome(s): One hundred seven records were included in the first period (79 colon and 28 rectal tumors) and 134 in the second (100 colon and 34 rectal tumors), with no significant differences between the number of patients nor the distribution by sex in both periods. In the colon tumors group, there were no significant differences between the groups of patients with early-stage (17), locally advanced (118), and metastatic (44) tumors between both periods. Nineteen patients (10.6%) underwent emergency surgery, 36 patients (20.1%) required an ostomy to be performed without significant differences in both periods. At the rectum tumor group, there were no significant differences concerning sex, nor pathological stage, where 17 (26.9%) were in the initial stages, 29 (46%) locally advanced, and 17 (26.9%) were metastatic. The laparoscopic approach was preferred in all tumor groups, requiring conversion in 6 (4.65%) colon tumor and 1 (2.17%) rectal tumor cases. No mortalities were recorded 30, 60, nor 90 days after Limitations: Among the limitations of our study is a selection bias, since it was carried out only in one institution, so the results obtained here are not necessarily extrapolated to the general population. Conclusions/Discussion: In patients operated in the oncology program of the Healthcare Network, there were no significant differences regarding the number of operated patients, their pathological stage, mortality, or approach in the compared periods.

Section Meetings

The annual student-themed Toronto Section Meeting took place on 15 February. A wide range of relevant topics were covered and presented in an easy-to-understand format that was suitable for student consumption. Due to COVID restrictions, it was necessary to collaborate remotely. © 2002 Society of Motion Picture and Television Engineers, Inc.