Inter-hospital transport of neonatal patients on extracorporeal membrane oxygenation: mobile-ECMO.

OBJECTIVE: To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program.

DESIGN: This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series.

SETTINGS: The study was conducted at a regional referral children's hospital and ECMO unit.

PATIENTS: Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO.

RESULTS: Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up data were available on all nine survivors of neonatal mobile-ECMO. Eight of these had normal magnetic resonance imaging scans of the brain; the ninth had a small hemorrhage in the left cerebellum.

CONCLUSION: Our limited series shows that patients can be safely transported with mobile-ECMO. This program does not replace the early appropriate transfer for ECMO-eligible patients to an ECMO center.