One Hundred Transports on Extracorporeal Support to an Extracorporeal Membrane Oxygenation Center.
BACKGROUND
Extracorporeal life support technology has gained acceptance as a salvage mode for patients in respiratory or cardiac failure. Patients who are sick enough to require extracorporeal membrane oxygenation (ECMO) support are often too unstable for transfer to a hospital with ECMO capabilities. We highlight the progressive development of an ECMO transport team and the manner in which it provides reliable transport with excellent outcomes.


METHODS
All data were collected retrospectively from our hospital's electronic medical record. Patient outcomes are reported through April 2, 2014.


RESULTS
Our institution began an ECMO transport program in 2008, with the initial phase involving transport of highly selected patients for short distances. With experience we refined our intake and evaluation process. We also consolidated care for ECMO patients into two intensive care units and developed a dedicated ECMO intensivist position. As the program has matured, patient selection has become more inclusive and we have extended our capabilities to include interstate and international transport. All 100 patients were successfully placed on ECMO and transported to our center. Seventy-nine patients were placed on venovenous ECMO, 19 on venoarterial ECMO, and 2 on venovenous arterial ECMO. The median transport distance was 16 miles and ranged from 2.5 to 7,084 miles.


CONCLUSIONS
Extracorporeal membrane oxygenation transport can be performed safely and reliably with excellent outcomes with a dedicated team that maintains stringent adherence to well-designed management protocols.
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
Mauer
M
Biscotti
Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Columbia University Medical Center, New York, New York.
Cara
C
Agerstrand
Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Columbia University Medical Center, New York, New York.
Darryl
D
Abrams
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
Mark
M
Ginsburg
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
Joshua
J
Sonett
New York-Presbyterian Hospital, New York, New York.
Linda
L
Mongero
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
Hiroo
H
Takayama
Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Columbia University Medical Center, New York, New York.
Daniel
D
Brodie
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York. Electronic address: mb2821@columbia.edu.
Matthew
M
Bacchetta
D000328:Adult; D002985:Clinical Protocols; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000592:standards / Q000706:statistics & numerical data