ECMO Transport without Physicians or Additional Clinicians.

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Medical Transport

Background:

• Extracorporeal membrane oxygenation (ECMO) use is increasing for severe cardiac/respiratory failure.
• Global ECMO networks utilize a "hub and spoke" model.
• Current guidelines mandate physician accompaniment for all ECMO transports, potentially limiting capacity.

Purpose of the Study:

• To compare adverse event rates during ECMO patient transport with and without an additional clinician (physician, NP, or PA).

Main Methods:

• Retrospective cohort study of adult ECMO transports (2011-2018) across 21 northeastern US hospitals.
• Compared ground and air transports with and without additional clinicians.
• Primary outcome: major adverse events; Secondary outcome: minor adverse events.

Main Results:

• 93 ECMO transports were analyzed; 24.7% were accompanied by an additional clinician.
• Major adverse events occurred in 21.5% of all transports.
• No significant difference in major adverse events between accompanied and unaccompanied transports (P = .91).

Conclusions:

• No association found between additional clinician accompaniment and major adverse events during ECMO transport.
• No variables were identified as predictive of major adverse events in either transport cohort.