ECMO is a Team Sport
Between 2010 and 2017, the number of ECMO cases and centers nearly doubled according to the ELSO registry report published January 2018. Research has shown that patient outcomes (survival rate and complications) are closely related to the volume of cases at individual centers. In this retrospective, single-institution cohort study at Massachusetts General Hospital in Boston, the institution of a formal multidisciplinary ECMO team resulted in a 14.6% increase in survival to discharge. Prior to the establishment of the formal ECMO team, all adult patients that were cannulated for ECMO, either VV or VA, remained in the ICU that they originated in (CCU, SICU, CSICU, and MICU).
Following the establishment of the formal team, all adult VV ECMO patients received care in the MICU and all adult VA ECMO patients received care in the CSICU. This allowed specific protocols and guidelines to be established and managed in a comprehensive fashion. The formal team consisted of cardiac surgeons, cardiac anesthesiologists, intensivists, cardiologists, ICU nursing staff, perfusionists, respiratory therapists, nutritionists, physical and occupational therapists, and an ethics committee member.
ECMO truly is a ‘team sport’ and should be approached in this manner to improve clinical outcomes and team communication.
Way to go, MGH ECMO team!
Submitted by Jeliene LaRocque RRT-NPS, RRT-ACCS, ECMO Advantage Specialist