What is an Extracorporeal Membrane Oxygenation (ECMO) centre?

From the Guidelines

An Extracorporeal Membrane Oxygenation (ECMO) centre is a specialized facility equipped to provide life-support therapy to patients with severe cardiac or respiratory failure, and should have sufficient experience, volume, and expertise to ensure safe use of ECMO 1.

Key Characteristics of an ECMO Centre

• Should maintain robust expertise in the care and ventilatory management of patients with severe acute respiratory failure (ARF) 1
• Should have an annual volume of at least 20 cases per year, with a minimum of 12 ECMO cases for ARF performed per year 1
• Should cover a catchment area of at least 2 to 3 million population 1
• Should have comprehensive plans regarding access to mobile ECMO and hold regular meetings to discuss network activity 1

Importance of Experience and Volume

• Centers with more than 20 to 25 cases per year have significantly better outcomes than centers with fewer cases 1
• The learning curve to establish competence requires at least 20 cases for optimal results 1
• Volume alone does not guarantee best practices or good outcomes, and other factors such as cumulative experience and continuing medical education should be taken into account 1

From the Research

Definition and Purpose of an ECMO Centre

An Extracorporeal Membrane Oxygenation (ECMO) centre is a specialized facility that provides life-support therapy for patients with severe heart or lung failure, where all other treatment options have failed or are unfeasible 2, 3, 4. The primary purpose of an ECMO centre is to offer a therapeutic option for patients with intractable cardio-respiratory conditions, providing them with a chance to survive until their organs can recover or until a more definitive treatment can be implemented.

Key Characteristics of an ECMO Centre

Some key characteristics of an ECMO centre include:

• Dedicated and specific management of patients with ECMO 2
• A well-planned program with consideration of all aspects, including economics, education and training, specialist team and equipment needed, strategies for medication, and ethical challenges 2
• The ability to provide veno-venous (VV) ECMO for respiratory support and veno-arterial (VA) ECMO for cardiac support 2, 3
• Advanced medical care and management of patients with severe respiratory failure 4, 5

Establishment and Operation of an ECMO Centre

The establishment and operation of an ECMO centre require:

• A planned program and concerted effort 2
• A specialist team with education and training in ECMO management 2
• Access to necessary equipment and resources 2, 5
• Consideration of economic and ethical challenges 2

Patient Outcomes and Efficacy of ECMO Centres

Studies have shown that ECMO centres can achieve good outcomes for patients with severe cardio-respiratory conditions, including:

• High survival rates for patients with respiratory failure 5
• Improved survival without severe disability for patients with severe hypoxemic respiratory failure 3
• Low mortality rates for patients with certain conditions, such as meconium aspiration syndrome and congenital diaphragmatic hernia 5