Related Experiment Video
Updated: Jul 4, 2026
06:41
Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
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
Summary
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.
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation (NIPPV)
Noninvasive Positive-Pressure Ventilation (NIPPV)
01:29Mechanical Ventilation I: Indication and Settings
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
01:21Acute Respiratory Failure-II
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:23Mechanical Ventilation II: Invasive Ventilation
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:30Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...