Safety of Interhospital Transport for Patients Receiving Extracorporeal Membranous Oxygenation Support.
Prehospital emergency care · 2026-01-08 · Observational study
Abstract
OBJECTIVES: Patients receiving extracorporeal membranous oxygenation (ECMO) support often have fragile conditions that make them susceptible to physiological deterioration during interhospital transport (IHT). This study aimed to assess the safety of IHT for ECMO-supported patients, utilizing a dedicated critical care transport team. METHODS: A retrospective analysis was conducted on patients who underwent IHT while receiving ECMO support in a metropolitan city between January 2016 and April 2024. The primary outcome was the occurrence of abnormal physiologic parameters during IHT, including hypotension (mean arterial pressure <65 mmHg), desaturation (pulse oximetry <90%), tachycardia (heart rate >120/min), and bradycardia (heart rate <50/min). RESULTS: A total of 151 patients were included in the study, with 96 (59.6%) on veno-arterial (VA)-ECMO and 55 (40.4%) on veno-venous (VV)-ECMO. Of these, 37.1% had experienced cardiac arrest prior to ECMO initiation. The median transport time from departure at the referring hospital to arrival at the receiving hospital was 25 min (interquartile range, 19-37 min). Several adverse events occurred during transport, including ECMO console shutdown in 8.9% of cases (n = 10 spontaneous shutdowns, n = 3 due to human error), all of which were appropriately managed by the trained transport team. Physiological parameters remained stable between the start and end of IHT, with a significant reduction in the prevalence of tachycardia (p < 0.01). CONCLUSIONS: Interhospital transport for ECMO-supported patients by a dedicated critical care transport team is safe. These findings support the implementation of specialized transport systems to facilitate the safe transfer of critically ill patients receiving ECMO support.