Two decades' experience with interfacility transport on extracorporeal membrane oxygenation

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Pediatric Medicine

Background:

• Limited data exist on outcomes for interfacility transport of patients on extracorporeal membrane oxygenation (ECMO).
• Few specialized centers perform a high volume of ECMO transports.
• Understanding outcomes is crucial for program evaluation and development.

Purpose of the Study:

• To evaluate the safety and outcomes of interfacility transport for patients requiring ECMO.
• To compare survival rates of transported ECMO patients with non-transported cohorts.
• To assess the feasibility of expanding ECMO transport programs.

Main Methods:

• Retrospective review of a 20-year single-institution experience with ECMO transport.
• Systematic review of published case series on ECMO transfers.
• Comparison of institutional and literature data with the Extracorporeal Life Support Organization (ELSO) registry.

Main Results:

• Over 20 years, 221 patients underwent ECMO transport to the institution, with a 62% survival to discharge.
• A systematic review of 643 transported patients across 27 series reported a 61% overall survival.
• Transported patients showed survival comparable to non-transported ECMO patients, with higher survival in pediatric respiratory failure cases.

Conclusions:

• Interfacility transport of critically ill patients on ECMO is feasible and safe.
• Survival outcomes for transported ECMO patients are comparable to age- and treatment-matched controls.
• These findings support the continued provision and potential expansion of ECMO transport services.