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Published on: October 24, 2018

Mobile versus in-center ECMO initiation in pediatric patients: a comparative outcome study

Jowita Rosada-Kurasińska1, Bartłomiej Kociński2, Mark T Ogino3

  • 1Poznan University of Medical Sciences, Department of Paediatric Anaesthesiology and Intensive Therapy.

Anaesthesia, Critical Care & Pain Medicine
|July 2, 2026
PubMed

Insights

Extracorporeal life support (ECLS) initiated at local hospitals by mobile teams and transported to specialized centers shows comparable outcomes to in-center ECLS. This approach is safe and effective for pediatric patients with severe respiratory or cardiopulmonary failure.

Area of Science:

  • Pediatric critical care medicine
  • Cardiopulmonary support technologies
  • Inter-hospital patient transfer protocols

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for severe respiratory or cardiopulmonary failure.
  • Persistent hypoxemia or hypercapnia despite maximal conventional therapy necessitates advanced support.
  • Indications for ECMO include conditions threatening life due to inadequate gas exchange.

Purpose of the Study:

  • To compare the characteristics and outcomes of pediatric patients receiving ECMO initiated at a specialized center versus those initiated at local hospitals followed by mobile ECMO team transport.
  • Evaluate the safety and efficacy of mobile ECMO services in pediatric critical care.
  • Assess the impact of transport on patient outcomes.

Main Methods:

  • Retrospective analysis of pediatric patients who received ECMO between 2018 and 2025.
  • Comparison of two groups: ECMO initiated at the specialized center (control) and ECMO initiated at local hospitals by a mobile cardiorespiratory assistance unit (mobile group).
  • Data collected included demographics, pre-ECMO parameters, and clinical outcomes such as survival, organ dysfunction, and support duration.

Main Results:

  • Twenty-four pediatric patients were analyzed. The mobile group (15 patients) had 80% survival to discharge, primarily for pediatric acute respiratory distress syndrome (PARDS). The control group (9 patients) had 78% survival.
  • No statistically significant differences were observed between groups in hepatic dysfunction, kidney failure, successful weaning, duration of extracorporeal support, pre-ECMO ICU stay, or ICU mortality.
  • Both approaches demonstrated similar clinical outcomes, supporting the feasibility of mobile ECMO initiation.

Conclusions:

  • Bedside initiation of Extracorporeal Life Support (ECLS) in local hospitals by mobile teams is safe and effective, with subsequent transport to referral centers yielding comparable outcomes.
  • The study validates the effectiveness of establishing an interregional network of mobile cardiorespiratory assistance units for pediatric critical care.
  • Mobile ECMO services facilitate timely access to advanced life support for critically ill children, regardless of initial hospital capabilities.
Abstract

Keywords:
acute respiratory failureextracorporeal membrane oxygenationintensive therapy unitpediatric patients

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