Mobile Extracorporeal Membrane Oxygenation Teams: The North American Versus the European Experience.
OBJECTIVE
To evaluate differences in the inclusion of anesthesiologists in mobile extracorporeal membrane oxygenation (ECMO) teams between North American and European centers.


METHODS
A retrospective review of North American versus European mobile ECMO teams. The search terms used to identify relevant articles were the following: "extracorporeal membrane transport," "mobile ECMO," and "interhospital transport."


METHODS
MEDLINE review of articles.


METHODS
None.


METHODS
None.


RESULTS
Between 1986 and 2015, 25 articles were published that reported the personnel makeup of mobile ECMO teams in North America and Europe: 6 from North American centers and 19 from European centers. The included articles reported a total of 1,329 cases: 389 (29%) adult-only cohorts and 940 (71%) mixed-age cohorts. Among North American studies, 0 of 6 (0%) reported the presence of an anesthesiologist on the mobile ECMO team in contrast to European studies, in which 10 of 19 (53%) reported the inclusion of an anesthesiologist (Fisher exact p for difference = 0.05). In terms of number of cases, this discrepancy translated to 543 total cases in North America (all without an anesthesiologist) and 499 cases in Europe (37%) including an anesthesiologist on the team (Fisher exact p for difference<0.001).


CONCLUSIONS
This study demonstrated significant geographic discrepancies in the inclusion of anesthesiologists on mobile ECMO teams, with European centers more likely to incorporate an anesthesiologist into the mobile ECMO process compared with North American centers.
Department of Anesthesiology, Yale School of Medicine, New Haven, CT.
Adambeke
A
Nwozuzu
Department of Anesthesiology, Yale School of Medicine, New Haven, CT.
Manuel L
ML
Fontes
Department of Anesthesiology, Yale School of Medicine, New Haven, CT. Electronic address: robert.schonberger@yale.edu.
Robert B
RB
Schonberger
D000776:Anesthesiology / Q000458:organization & administration*; D005060:Europe; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D009656:North America; D010348:Patient Care Team / Q000458:organization & administration*; D010360:Patient Transfer / Q000458:organization & administration; D012189:Retrospective Studies
anesthesiology; extracorporeal membrane oxygenation; mobile ECMO
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