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Extracorporeal membrane oxygenation (ECMO) transport
Extracorporeal membrane oxygenation (ECMO) is a mechanical support therapy we use to optimize cellular level respiration to fulfill the metabolic demands of critically ill patients with respiratory and/or cardiac failure. In simple terms, an ECMO machine is used to take over the work of the lungs and sometimes the heart. ECMO extracts a patient’s blood with low levels of oxygen, removes the CO2 (both of which are functions healthy lungs typically perform so our body can function properly), then puts oxygen in that blood and returns it to the body to be distributed to the organs and tissues.
In a patient with a failing heart, it can return that oxygenated blood directly to the systemic arteries for its redistribution, taking over the pumping function of the heart itself. Historically, ECMO use was reserved for those patients whose risk of mortality using conventional therapies, such as invasive mechanical ventilation and/or vasopressors in high doses, was higher than 80 percent. As the technology improved, along with our expertise in leveraging it, we now also use ECMO to help prevent organ injury associated with the use of extreme conventional therapy support, such as ventilator-induced lung injury.
At Texas Children’s’ Hospital we have a state-of-the-art ECMO team that performs up to 50 cases of ECMO a year, with outcomes equal or better than the national standards. This is why, at Texas Children’s, we believe the most critically ill children at other institutions with less technical resources should also benefit from ECMO. It is because of this that our ECMO transport team was created. Texas Children’s ECMO transport team members are experts in emergency transport medicine and ECMO. We can start ECMO support on severely ill patients at other institutions and bring them to Texas Children’s for further management, or go retrieve patients already on ECMO who need a higher level of care and expertise.
We transport patients either by road or air, providing ECMO support at all times. Transport on ECMO has been proven to be safe, and our outcomes in transporting these critically ill patients are comparable to other non-transport related patients who receive ECMO support. We work with many organizations, locally and nationally, to provide ECMO transport services for their patients who need a higher level of care. Early recognition is key to providing the best possible outcomes for these critically ill children in need of our expertise and who would benefit from ECMO support.