Extracorporeal Membrane Oxygenation During Aeromedical Transport of Cardiovascular Critical Care Patients: Evidence-Based Frameworks and Clinical Challenges.
Journal of cardiothoracic and vascular anesthesia · 2026-04-28 · Other / unclear
Abstract
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) aeromedical transport presents the most complex logistical and clinical interface in critical care medicine. This review synthesizes contemporary evidence regarding the retrieval of cardiovascular patients on VA-ECMO, focusing on the operational nuances of helicopter emergency medical services. This study presents a comprehensive analysis of (1) the interplay between flight-specific stressors, (2) technical innovations for circuit stability, and (3) clinical outcomes. A critical benchmark of operational success is the mitigation of category 2 severe complications-events requiring immediate clinical intervention to prevent morbidity. By integrating flight physiology with device engineering, this review establishes a standardized framework for optimizing transport safety, emphasizing that while peri-transport mortality is negligible in specialized programs, high-fidelity monitoring remains essential.