Retrieval of critically ill adults using extracorporeal membrane oxygenation: an Australian experience

Abstract

Patients with very severe respiratory failure, which was considered to preclude conventional ventilation for safe transfer to tertiary centres, were managed by an ECMO referral and retrieval program in NSW and had a high rate of survival. This program also enhanced the capacity of the state to respond to a surge in demand for ECMO support due to the H1N1 epidemic, although the role of ECMO in respiratory failure is not yet well defined.

Capabilities of a mobile extracorporeal membrane oxygenation service for severe respiratory failure delivered by intensive care specialists

“…Despite the lack of surgical involvement common to other studies [18][19][20], there were no cannulation failures or significant ECMO complications. There were also no major adverse events during transfer.…”

“…On arrival back at our centre, the median (IQR [range]) Acute Physiology And Chronic Health Evaluation (APACHE) II and maximum Sequential Organ Failure Assessment (SOFA) scores were 17 (14-21 ) and 12 (9-15 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]), respectively. After transfer on ECMO, there were significant improvements in PaO 2 /F I O 2 ratio, ventilator F I O 2 , plateau mechanical ventilation pressure, pH and arterial PCO 2 (Table 3).…”

Inter-hospital transports on extracorporeal membrane oxygenation in different health-care systems

“…It is more the local experience, climate, health care culture, and funding and resources that form how these teams finally will be organized, staffed etc. (2,15,23,24,30,31).…”

“…However, shortly after the onset of the H1N1 pandemic between 2009 and 2010 such transport systems became a necessity. Some countries had the experience and an infra-structure for long distance transports of intensive care patients, but less experience of transports on ECMO (2). In a short timeframe emergency hospitals and intensive care departments had to organize and establish routines for transfers of patient on ECMO.…”

Application of extracorporeal membrane oxygenation in severe ARDS secondary to pneumonia: a case report

“…Extracorporeal membrane oxygenation (ECMO) therapy has been used to treat patients with ARDS; this treatment has been associated with a reduction in death or severe disability within the first 6 months of the therapy [2]. The main clinical applications of ECMO have been for the management of life-threatening pulmonary or cardiac failure [3,4] and for the safe transport of the critically ill patients, especially during the H1N1 pandemic [5,6]. ECMO has also been used in patients with septic shock [7], severe trauma [8], and profound hypothermia [9].…”