Five-year experience with mobile adult extracorporeal membrane oxygenation in a tertiary referral center

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Abstract

Introduction

Mobile extracorporeal membrane oxygenation (ECMO) is reserved for critically unstable patients who may not otherwise survive transfer to the ECMO center. We describe our experience with mobile ECMO.

Methods

We retrospectively reviewed adult patients between 2010 and 2014 who were referred for ECMO support and were too unwell for conventional transfer. They were cannulated at their referring center by our team and subsequently transported back to our hospital on ECMO.

Results

A total of 102 patients were put on ECMO by our team. Of 102 patients, 95 (93%) were managed by venovenous ECMO, and 7 (7%), by venoarterial ECMO. The average distance traveled was 195 miles (SD, ± 256.8; range, 3.6-980). Transportation was via road in 77 cases (77%), by air in 22 cases (22%), and in 3 cases (3%) a combination of road and air was used. A double-lumen Avalon cannula was used in 72 patients (70%). One patient had a ventricular tachycardia arrest during cannulation but was successfully resuscitated. There was no mortality or major complications during transfer.

Conclusion

The use of mobile ECMO in adult patients is a safe modality for transfer of critically unwell patients. We have safely used double-lumen cannulas in most of these patients.

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