The Medical ECMO Program: Transport

Dr. Matthew Bacchetta: We were consulted on a very young patient who was essentially dying at another hospital not too far from our own. We had been planning on trying to do ECMO Transport for a while and we were looking for that opportune moment when we could do it, and this young patient happened to present. She was gravely ill, in fact by the time we arrived there she had already had a cardiopulmonary arrest. We put her on ECMO emergently and we transported her back. Thankfully she did very well, she’s alive and well today, and we took that experience along with subsequent experiences and developed a full-fledged ECMO program.

Dr. Cara Agerstrand: Patients we transport on ECMO are typically people who have very severe forms of respiratory failure, very severe pneumonias, very severe forms of the Acute Respiratory Distress Syndrome, or ARDS, conditions that would make them unsafe to transport without the addition of ECMO support.

Dr. Matthew Bacchetta: We’ve also used our ECMO transport progam to bring in severely ill patients with Acute Pulmonary Embolisms which have a very high mortality if not managed acutely and correctly.

Dr. Cara Agerstrand: Once we accept a patient for ECMO our transfer center provides and sends a checklist to the referring facility. That checklist includes all the steps that we recommend the hospital follow in order to prepare the patient for ECMO Transport. Once our transport team arrives we kind of bring the whole package with us, we bring a surgeon, a surgical fellow, a perfusionist, and all the equipment we would need to place a patient safely on ECMO at the referring hospital. We would typically perform the procedure at the patient’s bedside and then transport them back to Columbia with the assistance of our critical care paramedics. One of the things we pride ourselves on at NYP Columbia is that we really have a multidisciplinary team of providers caring for the patients, anywhere from our medical team consisting of surgeons, medical intensivists, nurse practitioners, nurses, specialized consultants, physical and occupational therapists, pharmacists, care coordinators and dedicated social workers who have experience taking care of ECMO patients and are well aware of the needs these specific patients and families might have.

Dr. Matthew Bacchetta: Our team has traveled over seven thousand miles to transport patients, but most of our transports occur within about a hundred mile radius of our hospital, and we always have a team available to ride.