ECMO cannulation across New England

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Medical Technology

Background:

• Extracorporeal membrane oxygenation (ECMO) use has risen over 15 years as a rescue therapy.
• Secondary ECMO transports are increasing as community hospitals cannulate patients without ECMO capabilities.

Purpose of the Study:

• To analyze trends in ECMO cannulations and the number of cannulating centers.
• To evaluate changes in extracorporeal cardiopulmonary resuscitation (ECPR) over time.

Main Methods:

• Retrospective review of inter-facility transports to ECMO centers in Boston.
• Data collected from 2011 to 2022, encompassing 202 cannulated and transported patients.

Main Results:

• The number of annual ECMO cannulations increased from 6 in 2011 to 36 in 2019.
• The number of cannulating centers grew from 3 in 2011 to 14 in 2022.
• A significant portion of patients (26.4%) required ECMO during cardiopulmonary resuscitation (ECPR), with a similar increasing trend in ECPR cases and sites.

Conclusions:

• Community-based ECMO cannulations are rising, particularly for high-acuity ECPR patients.
• The increasing volume of cannulations at non-ECMO centers necessitates improved coordination with transport organizations and ECMO centers to manage this patient population.