Implementation of Extracorporeal Membrane Oxygenation Without On-Site Cardiac Surgery or Perfusion Support: A Tale of Two County Hospitals

Kyle S. Bilodeau, Jenelle Badulak, Eileen Bulger, Barclay Stewart, Samuel P. Mandell, Mark Taylor, Anna Condella, Michelle D. Carlson, Louis P. Kohl, Nicholas S. Simpson, Beth Heather, Matthew E. Prekker, Nicholas J. Johnson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Patients with refractory respiratory and cardiac failure may present to noncardiac surgery centers. Prior studies have demonstrated that acute care surgeons, intensivists, and emergency medicine physicians can safely cannulate and manage patients receiving extracorporeal membrane oxygenation (ECMO). Harborview Medical Center (Harborview) and Hennepin County Medical Center (Hennepin) are both urban, county-owned, level 1 trauma centers that implemented ECMO without direct, on-site cardiac surgery or perfusion support. Both centers 1) use an ECMO specialist model staffed by specially trained nurses and respiratory therapists and 2) developed comparable training curricula for ECMO specialists, intensivists, surgeons, and trainees. Each program began with venovenous ECMO to provide support for refractory hypoxemic respiratory failure and subsequently expanded to venoarterial ECMO support. The coronavirus disease 2019 (COVID-19) pandemic created an impetus for restructuring, with each program creating a consulting service to facilitate ECMO delivery across multiple intensive care units (ICUs) and to promote fellow and resident training and experience. Both Harborview and Hennepin, urban county hospitals 1,700 miles apart in the United States, independently implemented and operate adult ECMO programs without involvement from cardiovascular surgery or perfusion services. This experience further supports the role of ECMO specialists in the delivery of extracorporeal life support.

Original languageEnglish (US)
Pages (from-to)E223-E229
JournalASAIO Journal
Volume69
Issue number6
DOIs
StatePublished - Jun 1 2023
Externally publishedYes

Keywords

  • extracorporeal membrane oxygenation
  • extracorporeal membrane oxygenation at noncardiac surgery center
  • extracorporeal membrane oxygenation program
  • extracorporeal membrane oxygenation specialist
  • extracorporeal membrane oxygenation without cardiothoracic surgery

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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