Economic Outcomes of Extracorporeal Membrane Oxygenation With and Without Ambulation as a Bridge to Lung Transplantation

ECMO Support in Lung Transplantation: A Contemporary Analysis of Hospital Charges in the United States

“…In keeping with other accounts in the literature, we reported that recipients who require ECMO support during LT tend to have longer, more complicated hospitalizations, characterized by comparatively higher hospital charges [11]. In this vein, the literature has often cited LOS as a major contributor to cost, and indeed health economists believe that reduction in LOS may significantly reduce overall health expenditure [16,17]. This theory has been supported by the costs incurred in the rehabilitation of deconditioned, immobile patients that has further fueled the promotion of ambulatory ECMO to counter the need for immobilization or for mechanical ventilation.…”

“…This theory has been supported by the costs incurred in the rehabilitation of deconditioned, immobile patients that has further fueled the promotion of ambulatory ECMO to counter the need for immobilization or for mechanical ventilation. Ambulatory support theoretically allows for more intensive rehabilitation and faster recovery, potentially shortening LOS after LT. Bain and colleagues [16] reported that this strategy allowed for a 25% decrease in costs. The group went further to cite other benefits such as the attenuation of both critical illness polyneuropathy and the deconditioning that frequently accompanies ECMO usage [16].…”

“…Ambulatory support theoretically allows for more intensive rehabilitation and faster recovery, potentially shortening LOS after LT. Bain and colleagues [16] reported that this strategy allowed for a 25% decrease in costs. The group went further to cite other benefits such as the attenuation of both critical illness polyneuropathy and the deconditioning that frequently accompanies ECMO usage [16]. In the same vein, Nosotti and colleagues [18] also reported that patients who could breathe spontaneously while on ECMO had increased survival compared with patients who were mechanically ventilated.…”

Visit to intensive care of 2050

“…Patients presenting with organ failure nonetheless undergo initial implantation of a bridging device in the ICU and are sent home until a new organ has been created for them [27,28]. This process is automated: once the hospital system is notified of such patient admission, it imports data regarding the pre-damage structure of the patient organs (individual 3-D organ mapping is mandatory at age 18).…”

Extracorporeal membrane oxygenation in the pre and post lung transplant period

“…Critically ill patients on prolonged mechanical ventilation and/ or ECMO support are prone to developing significant neuro-muscular weakness (76,77). Several studies have demonstrated that physical rehabilitation in patients on ECMO support is safe and can potentially improve post-transplant recovery and outcomes (25,29,39,78,79). Ambulation can be safely achieved in patients cannulated via a DLC in a VV configuration or subclavian/central VA configuration (48,(80)(81)(82).…”