INTERHOSPITAL 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 desi gn and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. Design. This is a report of a technique for the transp ort of patients on ECMO and a description of our retrospective case se ries. Settings. The study was conducted at a regional referral childre n's hospital and ECMO unit. Patients. Thirteen neonatal medical patien ts with acute respiratory failure were transported with mobile-ECMO. R esults. Over a 24-month period, we transported 13 neonatal patients wi th mobile-ECMO. The reason for transport with mobile-ECMO was inabilit y to convert from high-frequency ventilation (4 of 13), patient alread y on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from o ther ECMO centers. Of the 13, 9 survived. No major complications durin g transport were reported for any of the patients. Follow-up data were available on all nine survivors of neonatal mobile-ECMO. Eight of the se had normal magnetic resonance imaging scans of the brain; the ninth had a small hemorrhage in the left cerebellum. Conclusion. Our limite d series shows that patients can be safely transported with mobile-ECM O. This program does not replace the early appropriate transfer for EC MO-eligible patients to an ECMO center.