Rapid Development and Implementation of an ECMO Program

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...

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Autores principales: Moll, Vanessa, Teo, Elrond Y.L., Grenda, David S., Powell, Cindy D., Connor, Michael J., Gartland, Bryce T., Zellinger, Mary J., Bray, H. Bruce, Paciullo, Christopher A., Kalin, Craig M., Wheeler, Jean M., Nguyen, Duc Q., Blum, James M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867977/
https://www.ncbi.nlm.nih.gov/pubmed/26735556
http://dx.doi.org/10.1097/MAT.0000000000000331
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author Moll, Vanessa
Teo, Elrond Y.L.
Grenda, David S.
Powell, Cindy D.
Connor, Michael J.
Gartland, Bryce T.
Zellinger, Mary J.
Bray, H. Bruce
Paciullo, Christopher A.
Kalin, Craig M.
Wheeler, Jean M.
Nguyen, Duc Q.
Blum, James M.
author_facet Moll, Vanessa
Teo, Elrond Y.L.
Grenda, David S.
Powell, Cindy D.
Connor, Michael J.
Gartland, Bryce T.
Zellinger, Mary J.
Bray, H. Bruce
Paciullo, Christopher A.
Kalin, Craig M.
Wheeler, Jean M.
Nguyen, Duc Q.
Blum, James M.
author_sort Moll, Vanessa
collection PubMed
description 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 intensive care unit discharge of 40%. Of the 16 patients, 10 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 an institutional commitment, a physician champion, multidisciplinary leadership, and organized training. Further study is required to determine whether outcomes will continue to improve.
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spelling pubmed-48679772016-06-03 Rapid Development and Implementation of an ECMO Program Moll, Vanessa Teo, Elrond Y.L. Grenda, David S. Powell, Cindy D. Connor, Michael J. Gartland, Bryce T. Zellinger, Mary J. Bray, H. Bruce Paciullo, Christopher A. Kalin, Craig M. Wheeler, Jean M. Nguyen, Duc Q. Blum, James M. ASAIO J How to Do It Article 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 intensive care unit discharge of 40%. Of the 16 patients, 10 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 an institutional commitment, a physician champion, multidisciplinary leadership, and organized training. Further study is required to determine whether outcomes will continue to improve. Lippincott Williams & Wilkins 2016-05 2016-01-05 /pmc/articles/PMC4867977/ /pubmed/26735556 http://dx.doi.org/10.1097/MAT.0000000000000331 Text en Copyright © 2016 by the American Society for Artificial Internal Organs This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle How to Do It Article
Moll, Vanessa
Teo, Elrond Y.L.
Grenda, David S.
Powell, Cindy D.
Connor, Michael J.
Gartland, Bryce T.
Zellinger, Mary J.
Bray, H. Bruce
Paciullo, Christopher A.
Kalin, Craig M.
Wheeler, Jean M.
Nguyen, Duc Q.
Blum, James M.
Rapid Development and Implementation of an ECMO Program
title Rapid Development and Implementation of an ECMO Program
title_full Rapid Development and Implementation of an ECMO Program
title_fullStr Rapid Development and Implementation of an ECMO Program
title_full_unstemmed Rapid Development and Implementation of an ECMO Program
title_short Rapid Development and Implementation of an ECMO Program
title_sort rapid development and implementation of an ecmo program
topic How to Do It Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867977/
https://www.ncbi.nlm.nih.gov/pubmed/26735556
http://dx.doi.org/10.1097/MAT.0000000000000331
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