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Long-Term Survival After Inter-Hospital Transfer with Extracorporeal Membrane Oxygenation (ECMO): A Retrospective
Yoganiranjana Dharuman1, Sami Sirat2, Mirko Doss2
1Department of Cardiothoracic Surgery, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Background:
Extracorporeal membrane oxygenation (ECMO) is a vital intervention for acute respiratory and cardiac failure. This study evaluates the outcomes, safety, and long-term survival of patients stabilized at external hospitals and transferred to a supra-regional center under ECMO support, comparing results with current global standards.
Methods:
A retrospective analysis was conducted on 20 patients (14 male, 6 female, mean age 50.6 years) transferred to our hospital. The cohort was divided into veno-venous (vv-ECMO, n = 16) and veno-arterial (va-ECMO, n = 4) support. Key metrics included weaning success, complication rates, and long-term survival determined via follow-up with a median follow-up of 23 months.
Results:
Inter-hospital transfer was highly safe; 0% mortality occurred during transport despite a mean distance of 28.7 km (max. 54 km). In the mixed cohort, weaning was successful in 60% of cases, evaluated via 30-day survival. Major complications occurred in eight patients (40%), including bleeding (n = 6) and compartment syndrome (n = 2). Long-term survival analysis showed that patients who survived the first 30 days had a high probability of continued long-term stability.
Conclusions:
Remote ECMO cannulation followed by inter-hospital transfer is a safe strategy. While va-ECMO patients face higher mortality due to the underlying severity of cardiac failure, vv-ECMO shows favorable survival rates for ARDS. The specialized "ECMO-retrieval team" model is essential for extending advanced life support to peripheral hospitals.