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ECMO program takes life-saving therapy on the road

Sep. 28, 2017, 10:31 AM

Vanderbilt University Medical Center (VUMC) is home to the state’s largest adult Extracorporeal Membrane Oxygenation (ECMO) Program. And most recently, it became the only adult program in Tennessee with a mobile team that can initiate ECMO on patients transported to the Medical Center by its ambulances.

ECMO technology provides temporary emergency mechanical support for critically ill patients to support heart and lung functions. External pumps and oxygenators remove carbon dioxide from the blood, replace it with life-saving oxygen and then return it to the patient’s circulatory system. The machine does the work for both sets of organs, allowing them to rest.

“With the creation of our transport team, we have now made this therapy available to every person in Tennessee regardless of location,” said Stuart McGrane, MBCHB, associate professor of Anesthesiology and ECMO medical director. “We are currently the only program in Tennessee that will actively place a patient hospitalized at another center on ECMO and then transport the patient to Vanderbilt for specialized care.

“We have the multidisciplinary expertise and resources to help others outside of our own walls. This requires resources that many hospitals are not equipped to provide.”

A patient on ECMO is supported around the clock by a specialized team of cardiologists, cardiac surgeons, critical care intensivists, perfusionists, advance practice providers, ECMO specialists, respiratory therapists and registered nurses.

Vanderbilt’s ECMO transport program began in January, has already provided service to 12 patients and expects to see continued growth.

“In the past five years, we have seen an increase in the use of ECMO nationwide,” said McGrane. “We were getting calls from hospitals asking for our help. This program is a response to that demand. We are committed to being a resource for the community.”

According to Michael Daly, MSN, MBA, R.N., administrative director at Vanderbilt Heart and Vascular Institute, Vanderbilt is one of six registered centers in Tennessee with ECMO programs. Only Vanderbilt provides transport/mobile service.

The program collaborates with Vanderbilt LifeFlight to provide both ground ambulance and airplane transports for patients. The LifeFlight team travels to any location within a 500-mile radius to initiate the life-saving therapy and then transports the patient back to VUMC.

Daly and McGrane point to the pioneering work at Monroe Carell Jr. Children’s Hospital at Vanderbilt for the ECMO program’s foundation. The ECMO program at Children’s Hospital is one of the largest and most successful in the world. Until 2013, the Children’s Hospital program also provided ECMO support for adult patients.

“It wasn’t until 2013 that we developed our own service for adult patients,” said Daly. “And with the recent growth and increasing demand, we have expanded our service to include assisting other hospitals.

“We are an academic medical center — we want to help patients who would benefit from this kind of technology while enhancing our knowledge and growing the science.”

The Vanderbilt ECMO transport program is not solely a hands-on technical service. The program also provides consults to teams throughout the country to help them navigate the best pathways to care for their patients.

McGrane and Daly said requests for transport have come from Virginia, Alabama and Louisiana.

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