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The "basic" approach: a single-centre experience with a cost-reducing model for paediatric cardiac extracorporeal
Massimo A Padalino1, Chiara Tessari1, Alvise Guariento1
1Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy.
Interactive Cardiovascular and Thoracic Surgery
|January 13, 2017
Summary
A basic Extracorporeal Membrane Oxygenation (ECMO) model, managed without a dedicated bedside specialist, offers comparable survival rates to standard care. This approach significantly reduces financial costs for pediatric cardiac patients.
Area of Science:
- Cardiovascular Surgery
- Pediatric Critical Care
- Health Economics
Background:
- Extracorporeal membrane oxygenation (ECMO) is a critical but resource-intensive therapy.
- High financial, technical, and human resource demands impact ECMO accessibility.
- Evaluating alternative ECMO management models is essential for optimizing healthcare systems.
Purpose of the Study:
- To assess the safety, clinical outcomes, and financial impact of a 'basic' ECMO support model.
- To determine if ECMO can be safely managed without constant bedside specialist presence.
- To compare the cost-effectiveness of a basic ECMO model against more resource-intensive configurations.
Main Methods:
- Retrospective single-center study of pediatric cardiac ECMO patients (January 2001 - March 2014).
- Outcomes analyzed included post-implant complications and survival rates.
- Activity-based costing compared the financial impact of basic ECMO versus full-resource models.
Main Results:
- The study included 121 pediatric patients, with 88% having congenital heart disease.
- Overall survival at weaning and 30 days was 58.6% and 30.6%, comparable to Extracorporeal Life Support Organization data.
- Basic ECMO demonstrated significant cost savings, ranging from €13,837 to €30,366 per patient.
Conclusions:
- A basic ECMO model, even without a dedicated bedside specialist, achieves satisfactory patient survival.
- This approach effectively reduces human, technical, and economic resource utilization.
- Implementing a basic ECMO model presents a viable strategy for lowering healthcare costs in pediatric cardiac care.
