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Extracorporeal Membrane Oxygenation Is a Team Sport: Institutional Survival Benefits of a Formalized ECMO Team

      Objectives

      At the authors’ institution, prior to 2014, patients requiring care in the peri-extracorporeal membrane oxygenation (ECMO) period were treated by intensivists with specific training in ECMO but worked independently. This isolated form of care was addressed in late 2013 with the formal initiation of an ECMO team. The authors wanted to assess the difference in overall mortality for ECMO patients cared for prior to the initiation of a multidisciplinary team compared to after its establishment.

      Design

      This was a retrospective chart review-based study.

      Setting

      This was a single-center university-based hospital setting.

      Participants

      The study included all adult patients at the authors’ institution who required ECMO support between the years 2009 and 2017.

      Interventions

      The new multidisciplinary ECMO team established a set of protocols and guidelines to care for ECMO patients. The formal ECMO team consisted of cardiac surgery, cardiac anesthesia, intensivists, cardiology heart failure specialist, intensive care unit nursing (NP/RN), perfusion services, respiratory therapy, nutrition, physical and occupational therapy, and an ethics committee member.

      Measurements and Main Results

      Manual chart review was conducted and survival to discharge was collected and separated into 2 groups, 2009 to 2013 (pre-ECMO team) and 2014 to 2017 (post-ECMO team). In a total of 279 charts reviewed, patients required ECMO support. Survival to discharge for patients between 2009 and 2013 was 37.7% compared to a survival to discharge of 52.3% between 2014 and 2017 (p value = 0.02).

      Conclusions

      Patients cared for after the initiation of an ECMO team showed improved survival compared to patients cared for prior to the creation of the ECMO team.

      Key Words

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