Development of an Inter-hospital transfer network for patients requiring extracorporeal membrane oxygenation during the COVID-19 Pandemic

ABSTRACT

Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment modality for patients with severe respiratory and cardiac failure. During the COVID-19 pandemic, the ability to utilize this service worldwide was limited by the number of facilities capable of providing ECMO support and their patient capacity. We describe an institution rapidly deploying an ECMO transport program to improve access to this service and optimize its capacity. As the only ELSO Center of Excellence in the state of Louisiana, and one of the few facilities that can provide this service in the state, our center had an obligation to expand our ability to provide access to ECMO support in our region. However, as we had not performed ECMO transport before the pandemic, we were faced with challenges in developing the infrastructure for a transport program. Due to limited resources and our emphasis on treating the maximum number of patients, we had to create and implement protocols simultaneously, refining them as we went. We relied on programs that had previously developed transport protocols and procedures for guidance, adapting their templates for our program's specific characteristics. Less than one month after obtaining our first CardiohelpTM system we performed our first ECMO transport by air. Over the next twelve months, we performed more than ten transports by air and ground successfully with no mortalities or complications during transport. Despite various obstacles, we succeeded in creating a transport service and improved our ability to provide ECMO support to patients throughout the state of Louisiana.