title: Two decades' experience with interfacility transport on extracorporeal membrane oxygenation.
abstract: BACKGROUND
  Interfacility transport of patients on extracorporeal membrane oxygenation (ECMO) has been performed in large numbers at only a few programs. Limited data are available on outcomes after ECMO transport to justify expanding or discontinuing these programs.
  
  
  METHODS
  This was a retrospective review of a 20-year, single-institution experience with interhospital ECMO transport as well as a systematic review of reports of transfers of patients on ECMO. Results of both were compared with historical data from the international registry of the Extracorporeal Life Support Organization (ELSO).
  
  
  RESULTS
  Between 1990 and 2012, ECMO was used to facilitate transport of 221 patients to our institution, and 135 (62%) survived to discharge. Review of an additional 27 case series describing ECMO transport of 643 patients showed an overall survival of 61%. After stratifying by age and primary indication for ECMO, survival of transported patients was not significantly different compared with all ECMO patients in the ELSO registry, with the exception of pediatric patients treated for respiratory failure (transported patients in this category had higher survival than those in the ELSO registry).
  
  
  CONCLUSIONS
  Interfacility transport on ECMO is feasible and can be accomplished safely in the critically ill. Survival of transported patients is comparable to age-matched and treatment-matched ECMO patients at large.
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: bbryner@med.umich.edu.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bryner
authors.affiliation: Extracorporeal Membrane Oxygenation Program, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Elaine
authors.initials: E
authors.lastname: Cooley
authors.affiliation: Extracorporeal Membrane Oxygenation Program, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: William
authors.initials: W
authors.lastname: Copenhaver
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Kristin
authors.initials: K
authors.lastname: Brierley
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Teman
authors.affiliation: Survival Flight, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Denise
authors.initials: D
authors.lastname: Landis
authors.affiliation: Extracorporeal Life Support Organization, Ann Arbor, Michigan.
authors.forename: Peter
authors.initials: P
authors.lastname: Rycus
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Mark
authors.initials: M
authors.lastname: Hemmila
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Napolitano
authors.affiliation: Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Haft
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Pauline K
authors.initials: PK
authors.lastname: Park
authors.affiliation: Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Bartlett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D012189:Retrospective Studies