Regional mobile ECMO team design and function

The demonstration of improved outcomes at high volume ECMO centers has prompted the call for the formation of ECMO networks, which could incorporate their ECMO experience with the development of mobile teams, available to retrieve patients at other hospitals with acute cardiopulmonary failure. In order to truly develop a regional center of excellence for acute respiratory failure, there are several key program requirements. The first is to create a team that is both capable of safely and efficiently performing mobile VV ECMO and to be able to provide this service 24 hours a day when needed. ECMO consultations may occur at any time during the day or night so that an established triage and communication algorithm should be designed. Standardized protocols for mobile ECMO implementation should mirror the protocol for placement at home institutions. Our program always brings our portable ultrasound machine and we perform a transesophageal echocardiography (TEE) on every patient receiving mobile ECMO. This allows us to evaluate the cardiac function, safely insert and manage wires, and evaluate cannula position. In this chapter we also review the equipment, personnel and transport logistics which must be considered when organizing a mobile ECMO program.