Rapid Development and Implementation of an ECMO program

• Type of Material: Article
• Authors: Vanessa Moll, Emory University; Elrond Teo, Emory University; David Grenda, Emory University; Cindy Powell, Emory University; Michael Connor, Emory University; Bryce Gartland, Emory University; Mary Zellinger, Emory University; H. Bruce Bray, Emory University; Christopher Paciullo, Emory University; Craig M. Kalin, Emory University; Jean M. Wheeler, Emory University; Duc Q Nguyen, Emory University; James Blum, Emory University
• Language: English
• Date: 2016-01-05
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © 2016 by the American Society for Artificial Internal Organs
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/MAT.0000000000000331
• Title of Journal or Parent Work: ASAIO Journal
• ISSN: 1058-2916
• Volume: 62
• Issue: 3
• Start Page: 354
• End Page: 358
• Keywords: outcome; extracorporeal membrane oxygenation; adult; implementation
• Research Categories: Health Sciences, Health Care Management; Health Sciences, General; Health Sciences, Nursing

Abstract

Extracorporeal membrane oxygenation (ECMO) is an established therapy in the management of patients with refractory cardiogenic shock or acute respiratory failure.In this report, we describe the rapid development and implementation of an organized ECMO program at a facility that previously provided ad hoc support. The program provides care for patients within the Emory Healthcare system and throughout the Southeastern United States.From September 2014 to February 2015, 16 patients were treated with either venovenous or venoarterial ECMO with a survival to decannulation of 53.3% and survival to ICU discharge of 40%. 10/16 patients were transfers from outside facilities of which 2 were remotely cannulated and initiated on ECMO support by our ECMO transport team. Complications included intracerebral hemorrhage, bleeding from other sites, and limb ischemia.The results suggest that a rapidly developed ECMO program can provide safe transport services and provide outcomes similar to those in the existing literature. Key components appear to be institutional commitment, a physician champion, multidisciplinary leadership, and organized training. Further study is required to determine if outcomes will continue to improve.