Objective

Evidence suggests that extra-coroporeal membrane oxygenation (ECMO) should be provided at tertiary centres only. There has been an increase in referrals of neonates and children for life-saving ECMO support. Safe and effective transport of these children to tertiary ECMO centres is becoming ever more essential. Mobile ECMO is an attractive option but requires robust mechanisms for effective transfer. We present the 3-year (2012-2015) paediatric mobile ECMO data at a leading ECMO centre in the UK.

Methods

A retrospective analysis found 115 patient episodes where the mobile ECMO team was dispatched for neonatal and paediatric transfers. The mobile ECMO team consisted of a surgeon trained in ECMO, ECMO cannulation and Intensive Care, an ECMO Specialist nurse and a Perfusionist. The median patient age was 2 days (range: 0 days–14 years); 65% were neonates, 22% were aged 1-24 months and 12% were aged over 2 years. Destinations were primarily our own unit (83%) followed by other hospitals (17%).

Results

Underlying pathology: respiratory 83%, cardiac 8%, sepsis unspecified 3%, cerebral 2%. Majority of respiratory diagnoses were meconium aspiration (45%) and congenital diaphragmatic hernia (17%). All neonates received veno-arterial cannulation. The majority of children above 2 years received veno-venous cannulation. All patients were cannulated at the referring centre, 99% by our team. 111 successful transfers were made. There were no deaths on transport.

Conclusion

Our experience suggests that mobile ECMO in children is a safe and reliable method for transport in the critically ill and should be considered as a viable alternative to conventional transport methods. With the dawn of more sophisticated cannulation, monitoring and transport methods, larger numbers of children can be put on ECMO in primary units earlier in their treatment process and be safely transferred to specialist centres.