Establishing an interhospital ECMO-transport program during a pandemic: Key lessons learned

Area of Science:

• Cardiology
• Intensive Care Medicine
• Respiratory Medicine

Background:

• The COVID-19 pandemic highlighted the need for efficient inter-hospital patient transfer solutions.
• Establishing extracorporeal membrane oxygenation (ECMO) transport programs is crucial but lacks extensive research, especially during pandemics.
• Limited studies exist on ECMO transfer protocols and real-world experiences during the COVID-19 pandemic.

Purpose of the Study:

• To evaluate the effectiveness of a mobile ECMO transport program for severe COVID-19 patients.
• To provide insights into establishing and maintaining ECMO transport programs.
• To assess the feasibility and safety of inter-hospital ECMO transports during a pandemic.

Main Methods:

• Retrospective analysis of 76 patients with severe hypoxic COVID-19 ARDS transferred under veno-venous ECMO support.
• Transports conducted by an experienced ECMO transport team between April 2020 and December 2021.
• Included both intracity and intercity transports within Istanbul and the Marmara Region.

Main Results:

• The average transport distance was 36.6 km (intracity: 17.5 km, intercity: 121 km).
• ECMO wean rate was 40.7%, with a survival to discharge rate of 38.1%.
• No major adverse events occurred during transport; one oxygen tank was replenished en route.

Conclusions:

• Mobile ECMO transport programs are feasible and effective, even during pandemics.
• Expert coordination and meticulous patient management are vital for successful ECMO transports.
• This study contributes valuable data on ECMO transport programs during the COVID-19 pandemic.