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ECMO (Extracorporeal Membrane Oxygenation)
Texas Children’s Hospital has one of the busiest and most successful ECMO programs in the world. It is available to patients in all critical care settings (PICU, CICU, Adult Congenital Heart Disease ICU, and NICU) within the hospital. And in partnership with the Kangaroo Crew transport team, it is also available to qualified patients outside the walls of Texas Children’s Hospital. In some cases, patients already on ECMO at a referring hospital but needing further care at Texas Children’s are transported on ECMO by ground or air. When a patient is too sick to risk a transfer off ECMO, the ECMO service will come to the referring hospital, place the patient on ECMO first, and then transport that patient on ECMO back to Texas Children’s Hospital.
In 2022, the ECMO team cared for a total of 70 patients for a total of 82 ECMO runs, with outcomes that exceed international averages. This year, as of August 1, we have treated 59 patients with 63 runs, with very similar results. Moreover, in part due to the COVID-19 pandemic with long respiratory ECMO runs in adult patients, we have seen a dramatic increase in ECMO hours since 2019 when we logged slightly more than 13,000 hours to 2021 when we accumulated more than 22,000 hours of time on pump.
In 2018, our center was designated a Center of Excellence at the Gold Level by the Extracorporeal Life Support Organization (ELSO), an international body of ECMO Centers dedicated to advancing quality, education and research in ECMO throughout the world. Last year we received our re-designation as a Center of Excellence, but this time at the Platinum level. This is the highest level conceded by ELSO and one held by about 30 ECMO centers worldwide.
For the academic year 2019-20, we inaugurated a 1-year ECMO “Fellowship” program and successfully recruited the first pediatric subspecialist to this training program. We have had a three “fellows” complete the program, and our 4th fellow will soon begin her 1-year stint. The fellows receive immersive experiences in both pediatric and adult ECMO, with extensive ECMO transport experience and have provided outstanding leadership both within the institution and outside our walls during their adult ECMO rotations. We describe that program and its mission, objectives, the application process and curriculum under the ECMO “Fellowship” tab.
In addition to the clinical service, faculty from Texas Children’s Hospital ECMO team maintain active research and teaching programs, and have been active in developing novel curricula, in Spanish, to train new teams developing ECMO programs in Latin America.
This year, on July 20, we established the first-ever ECMO Specialists’ Day at Texas Children’s Hospital. The goal of the days was to recognized the tremendous efforts put forth by our ECMO specialists. Activities included presentations by a retired cardiac surgeon, who paid great respect to the importance of ECMO specialists, as he shared his views on his unique experience as both an ECMO surgeon and ECMO patient prior to his own lung transplant, and by the perfusionist who inaugurated the ECMO specialist program here at Texas Children’s Hospital.
We have an extensive quality improvement program, and last year inaugurated a monthly quality improvement conference that also meets an American College of Surgery requirement to review all ECMO mortalities. The conference is called EPIC (ECMO Performance Improvement Conference). We have also sponsored an educational conference series on Mechanical Circulatory Support that we open to anyone interested in learning. We invite a mix of local and internationally recognized speakers to share their expertise with all who join the call, and have had attendees from around the world log in every other Thursday to listen to these presentations and ask questions of the expert presenters. You, too, are free to join these sessions by clicking on the following link every other Thursday at 1 PM CST/CDT, but please contact us to receive the login password.
Finally, Texas Children’s Hospital is hosting an international symposium on pediatric extracorporeal and paracorporeal technologies, entitled PPETS. This an NIH-sponsored, biannual virtual symposium dedicated to gathering international experts in ECMO, VAD, dialysis and other renal replacement therapies, MARS and pheresis technologies to define knowledge gaps and research priorities in 6 different domains for the next 15-20 years. The domains include: Outcomes, Quality, Pharmacokinetics, Ethics, Innovation, Combined Circuits The first Summit will be held October 17-18, 2022. Please visit here for more information and to register for PPETS.
Many thanks for your interest in our ECMO program and do not hesitate to contact us if you would like further information.