The Southern California Extracorporeal Membrane Oxygenation Consortium During the Coronavirus Disease 2019 Pandemic

Area of Science:

• Critical Care Medicine
• Pandemic Preparedness
• Health Systems Management

Background:

• The COVID-19 pandemic created unprecedented demand for critical care resources, including extracorporeal membrane oxygenation (ECMO).
• Effective management of limited ECMO resources was crucial for equitable patient care during the public health crisis.
• A coordinated regional approach was necessary to address potential resource limitations.

Purpose of the Study:

• To establish guidelines for equitable and resource-effective ECMO delivery during the COVID-19 pandemic in San Diego County.
• To create a collaborative model for managing ECMO resources across multiple centers.
• To ensure maximal community benefit from limited ECMO availability.

Main Methods:

• Formation of the Southern California Extracorporeal Membrane Oxygenation (ECMO) Consortium involving 4 San Diego County centers.
• Development of guidelines reviewed by a biomedical ethicist and integrated into county resource allocation plans.
• Implementation of weekly virtual conferences for capacity monitoring, data sharing, and case discussion.
• Facilitation of equipment exchange between centers to maximize regional capacity.

Main Results:

• The consortium successfully placed 97 patients on ECMO between March 1 and November 30, 2020.
• No eligible patients were denied ECMO due to lack of resources or capacity.
• The collaborative model ensured equitable access to critical care.

Conclusions:

• The Southern California ECMO Consortium effectively optimized ECMO resource allocation during the COVID-19 pandemic.
• The consortium's model demonstrates a successful strategy for managing scarce critical care resources.
• This approach can serve as a valuable template for other regions facing similar public health emergencies.