Outcome and Cost of Nurse-Led vs Perfusionist-led Extracorporeal Membrane Oxygenation

Dhamija, Ankit; Kakuturu, Jahnavi; Schauble, Drew; Hayanga, Heather K.; Jacobs, Jeffrey P.; Badhwar, Vinay; Hayanga, J.W. Awori

doi:10.1016/j.athoracsur.2021.04.095

Cited by 14 publications

(17 citation statements)

References 21 publications

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“…Some literature shows that nurse‐led ECMO management has no difference in survival compared to perfusion‐led ECMO management and may have cost benefits. 14 …”

Section: Discussionmentioning

confidence: 99%

“…Its simplicity of use allowed our MICU nurses to quickly become comfortable with the set‐up and were able to adjust settings as necessary. Some literature shows that nurse‐led ECMO management has no difference in survival compared to perfusion‐led ECMO management and may have cost benefits 14 …”

Section: Discussionmentioning

confidence: 99%

“…Some literature shows that nurse-led ECMO management has no difference in survival compared to perfusion-led ECMO management and may have cost benefits. 14 ECMO was becoming more common in small-and medium-size hospitals even before the COVID-19 pandemic. 4 Data have shown that higher prepandemic ECMO volume does not result in lower mortality for COVID-19 ECMO patients.…”

Section: Complicationsmentioning

confidence: 99%

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Coronavirus 2019 (COVID‐19) venovenous extracorporeal oxygenation: Single community hospital results and insights

West

Nutting

Daughtry

et al. 2022

Journal of Cardiac Surgery

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Background The role of extracorporeal membrane oxygenation (ECMO) for patients with refractory respiratory failure due to coronavirus 2019 (COVID‐19) is still unclear even now over a year into the pandemic. ECMO is becoming more commonplace even at smaller community hospitals. While the advantages of venovenous (VV) ECMO in acute respiratory distress syndrome (ARDS) from COVID‐19 have not been fully determined, we believe the benefits outweighed the risks in our patient population. Here we describe all patients who underwent VV ECMO at our center. Methods All patients placed on ECMO at our center since the beginning of the pandemic, May 5, 2020, until February 20, 2021 were included in our study. All patients placed on ECMO during the time period described above were followed until discharge or death. The primary endpoint was in‐hospital death. Secondary outcomes included discharge disposition, that is, whether patients were sent to a long‐term acute care center (LTAC), inpatient rehabilitation, or went directly home. Results A total of 41 patients were placed on VV ECMO for refractory acute respiratory failure. Survival to discharge, the primary end point, was 63.4% (26/41). Inpatient mortality was 36.6% (15/41). Conclusions We show here that a successful high‐volume VV ECMO program for ARDS is achievable at even a medium‐size community hospital. We think our success can be replicated by most small‐ and medium‐size community hospitals with cardiothoracic surgery programs and intensivist teams.

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“…Some literature shows that nurse‐led ECMO management has no difference in survival compared to perfusion‐led ECMO management and may have cost benefits. 14 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Coronavirus 2019 (COVID‐19) venovenous extracorporeal oxygenation: Single community hospital results and insights

West

Nutting

Daughtry

et al. 2022

Journal of Cardiac Surgery

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“…How the team is ultimately built depends on the structure of the hospital and intensive care unit. 46 , 47 , 48 The number of interventions carried out and the orientation of the department (adult, pediatric or neonatal, cardiac, respiratory or both) also influence the size of the team and the need for training and further education. Center volume versus outcome relationship in ECLS is also controversial and there are conflicting studies on how close this relationship is.…”

Section: Ecls As a Team Approachmentioning

confidence: 99%

Human factors in ECLS – A keystone for safety and quality – A narrative review for ECLS providers

et al. 2021

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Introduction Although the technology used for extracorporeal life support (ECLS) has improved greatly in recent years, the application of these devices to the patient is quite complex and requires extensive training of team members both individually and together. Human factors is an area that addresses the activities, contexts, environments, and tools which interact with human behavior in determining overall system performance. Hypothesis Analyses of the cognitive behavior of ECLS teams and individual members of these teams with respect to the occurrence of human errors may identify additional opportunities to enhance safety in delivery of ECLS. Results The aim of this article is to support health‐care practitioners who perform ECLS, or who are starting an ECLS program, by establishing standards for the safe and efficient use of ECLS with a focus on human factor issues. Other key concepts include the importance of ECLS team leadership and management, as well as controlling the environment and the system to optimize patient care. Conclusion Expertise from other industries is extrapolated to improve patient safety through the application of simulation training to reduce error propagation and improve outcomes.

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“…For patients with acute respiratory distress syndrome (ARDS) or severe cardiogenic shock, extracorporeal membrane oxygenation (ECMO) is a highly complex life-saving therapy that provides oxygen to their bodies, allowing their hearts and lungs to recover. 1 Though effective for the care of patients with ARDS secondary to COVID-19, ECMO therapy for more than 10 days often costs patients more than $1,000,000 and requires close monitoring by highly skilled health care professionals. 1 , 2 Over the last 2.5 years, nearly 80 million Americans contracted COVID-19, leading to high numbers of patients with ARDS needing ECMO.…”

mentioning

confidence: 99%

Implementing Nurse Extracorporeal Membrane Oxygenation Specialists to Maintain a Sustainable Program

Boyd¹,

Lyle-Edrosolo²

2023

Nurse Leader

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Outcome and Cost of Nurse-Led vs Perfusionist-led Extracorporeal Membrane Oxygenation

Cited by 14 publications

References 21 publications

Coronavirus 2019 (COVID‐19) venovenous extracorporeal oxygenation: Single community hospital results and insights

Coronavirus 2019 (COVID‐19) venovenous extracorporeal oxygenation: Single community hospital results and insights

Human factors in ECLS – A keystone for safety and quality – A narrative review for ECLS providers

Implementing Nurse Extracorporeal Membrane Oxygenation Specialists to Maintain a Sustainable Program

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