Single-institution experience with interhospital extracorporeal membrane oxygenation transport: A descriptive study.
OBJECTIVE
Patients with refractory cardiopulmonary failure may benefit from extracorporeal membrane oxygenation, but extracorporeal membrane oxygenation is not available in all medical centers. We report our institution's nearly 20-yr experience with interhospital extracorporeal membrane oxygenation transport.


METHODS
Retrospective review.


METHODS
Quaternary care children's hospital.


METHODS
All patients undergoing interhospital extracorporeal membrane oxygenation transport by the Arkansas Children's Hospital extracorporeal membrane oxygenation team.


METHODS
Data (age, weight, diagnosis, extracorporeal membrane oxygenation course, hospital course, mode of transport, and outcome) were obtained and compared with the most recent Extracorporeal Life Support Organization Registry report.


RESULTS
Interhospital extracorporeal membrane oxygenation transport was provided to 112 patients from 1990 to 2008. Eight were transferred between outside facilities (TAXI group); 104 were transported to our hospital (RETURN group). Transport was by helicopter (75%), ground (12.5%), and fixed wing (12.5%). No patient died during transport. Indications for extracorporeal membrane oxygenation in RETURN patients were cardiac failure in 46% (48 of 104), neonatal respiratory failure in 34% (35 of 104), and other respiratory failure in 20% (21 of 104). Overall survival from extracorporeal membrane oxygenation for the RETURN group was 71% (74 of 104); overall survival to discharge was 58% (61 of 104). Patients with cardiac failure had a 46% (22 of 48) rate of survival to discharge. Neonates with respiratory failure had an 80% (28 of 35) rate of survival to discharge. Other patients with respiratory failure had a 62% (13 of 21) rate of survival to discharge. None of these survival rates were statistically different from survival rates for in-house extracorporeal membrane oxygenation patients or for survival rates reported in the international Extracorporeal Life Support Organization Registry (p > .1 for all comparisons).


CONCLUSIONS
Outcomes of patients transported by an experienced extracorporeal membrane oxygenation team to a busy extracorporeal membrane oxygenation center are very comparable to outcomes of nontransported extracorporeal membrane oxygenation patients as reported in the Extracorporeal Life Support Organization registry. As has been previously reported, interhospital extracorporeal membrane oxygenation transport is feasible and can be accomplished safely. Other experienced extracorporeal membrane oxygenation centers may want to consider developing interhospital extracorporeal membrane oxygenation transport capabilities to better serve patients in different geographic regions.
Clement
Katherine C
KC
Department of Pediatrics, University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR, USA.
Fiser
Richard T
RT
Fiser
William P
WP
Chipman
Carl W
CW
Taylor
Bonnie J
BJ
Heulitt
Mark J
MJ
Moss
Michele
M
Fasules
James W
JW
Faulkner
Sherry C
SC
Imamura
Michiaki
M
Fontenot
Eudice E
EE
Jaquiss
Robert D B
RD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001131:Arkansas; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000379:methods*; D055815:Young Adult