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Mobile ECMO for inter-hospital transport of pediatric patients: experience from 22 cases
Yufan Yang1,2, Xiangni Wang1,3, Xiulan Lu1,2
1Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children's Hospital), Changsha, Hunan, China.
Insights
Mobile extracorporeal membrane oxygenation (ECMO) transport is safe and effective for critically ill children. This study highlights successful inter-hospital transports, with most patients recovering and being discharged, demonstrating improved patient outcomes.
Area of Science:
- Pediatric critical care medicine
- Cardiopulmonary support technologies
- Inter-hospital patient transfer protocols
Background:
- Critically ill pediatric patients often require extracorporeal membrane oxygenation (ECMO) for life support.
- Inter-hospital transport of these vulnerable patients presents unique logistical and clinical challenges.
- Establishing safe and effective mobile ECMO transport is crucial for timely access to specialized care.
Purpose of the Study:
- To summarize the management experience of inter-hospital transport for critically ill children on ECMO.
- To provide evidence supporting the use of mobile ECMO for pediatric inter-hospital transport.
- To identify key factors for successful mobile ECMO transport in critically ill children.
Main Methods:
- Retrospective analysis of 22 critically ill pediatric patients transported via ambulance with ECMO support.
- Evaluation of patient demographics, primary diagnoses, transport details, and clinical outcomes.
- Review of management strategies including individual protection, transport procedures, equipment, teamwork, monitoring, and quality control.
Main Results:
- 22 pediatric patients successfully underwent inter-hospital ECMO transport, with a median age of 76 months.
- Primary diagnoses included ARDS, myocarditis, avian influenza, heart failure, and persistent pulmonary hypertension.
- No transport complications were reported; 17 patients recovered and were discharged, while 5 developed multi-organ failure post-ECMO.
- No infections occurred among transport staff.
Conclusions:
- Mobile ECMO transport for critically ill children can be performed safely and effectively.
- A well-equipped technical team and optimized procedures enhance the availability and safety of mobile ECMO.
- This approach can save lives by enabling timely transfer of critically ill pediatric patients.
Objective:
To summarize the management experience of inter-hospital transport of critically ill children with extracorporeal membrane oxygenation (ECMO) in our hospital and provide evidence for the mobile ECMO for inter-hospital transport of pediatric patients.
Methods:
Critically ill patients treated with ECMO transported to our hospital from January 2020 to July 2025 were included in this study and analyzed general information, disease types, cannulation methods, ECMO transport distances, patient conditions before and after ECMO deployment, complications during the transport, and outcome. The lesson was drawn up regarding individual protection, transport procedures, transport equipment, teamwork, monitoring during transport, and quality control, providing an evidence-based foundation for the mobile ECMO for inter-hospital transport process of critically ill children.
Results:
A total of 22 critically ill pediatric patients were successfully transported to our hospital supported with ECMO by ambulance. The oldest child was 13-years-old, and the median age of the cohort was 76.00 (19.00, 132.00) months. The primary diseases included acute respiratory distress syndrome (ARDS), fulminant myocarditis, avian influenza, heart failure, and persistent pulmonary hypertension of the neonate. The median transport distance was 180.00 (134.00, 233.00) km, and the patients had no complications during the transport. Subsequently, 17 patients recovered and were discharged from the hospital. Five patients developed with multiple organ failure soon after the separation of ECMO. The ECMO duration was 126.50 (83.00, 155.00) h. No infection in any medical staff and nursing staff.
Conclusion:
The availability and safety of mobile ECMO for inter-hospital transport of critically ill children could be improved with the support of a well-equipped technical team in a time-effective manner, saving patient lives.
