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Introduction Extracorporeal membrane oxygenation ECMO) [1] is used in the treatment of patients with extremely severe but potentially reversible pulmonary disorders. Today over 22,000 patients have been reported by about 120 ECMO centers [2]. The overall survival rate is 86 %, 62 %, and 54 % in neonates, pediatric patients, and adult patients with respiratory failure, respectively. In neonates several randomized studies have proven ECMO V.LindØn K. PalmØr J. Reinhard R. Westman H. EhrØn T. Granholm B. Frenckner Inter-hospital transportation of patients with severe acute respiratory failure on extracorporeal membrane oxygenation ± national and international experience Received: 5 February 2001 Final revision received: 18 June 2001 Accepted: 17 July 2001 Published online: 23 August 2001 Springer-Verlag 2001 H. EhrØn ´ T. Granholm ´ B. Frenckner ) ) Department of Pediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska Hospital, Karolinska Institutet, SE-171 76 Stockholm, Sweden E-mail: [email protected] Phone: +46-8-51 77 76 96 Fax: +46-8-51 77 77 12 V.LindØn ´ K.PalmØr ´ J. Reinhard ´ R. Westman Department of Pediatric Anesthesiology and Intensive Care, Astrid Lindgren Children's Hospital, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden Abstract Objective: To evaluate the experiences and results from inter- hospital transportation of patients with acute respiratory failure on extracorporeal membrane oxygenation ECMO). Design: Observational, descriptive study. Setting: Tertiary referral center in a University Hospital. Subjects and methods: When stan- dard ECMO criteria were fulfilled and the patient considered too un- stable for a conventional transport, the mobile ECMO team cannulated the patient for ECMO at the referring hospital. The patients were then transported to our ECMO center by ground ambulance, helicopter or fixed-wing vehicle. Patients were also transported on ECMO from our ECMO center to other centers due to shortage of available ECMO beds. Results: 29 patients 15 neonates, seven pediatric, and seven adult patients) with acute respiratory failure were transported on ECMO on a total of 30 occasions. Median time from arrival of the ECMO team at the referring hospital until the patient was on ECMO 28 patients) was 2.2 h range 1.25±4.25 h). The median time that the transport team was out was 10 h range 5.5±36.5 h) and the median time with the patient was 6 h range 3±30.5 h). The distance of transport ranged from 4±1,500 km. Six transports were international. No patient complications occurred during the transports. Two technical complications related to the transport vehicle were en- countered. One ambulance com- pressor malfunctioned. During one helicopter transport, one out of two electric supply circuits malfunctioned. The patients were not af- fected. Twenty-one of the 29 patients survived to discharge 72 %). None of the deaths was transport related. Conclusions: Tertiary intensive care units and ECMO centers require a dedicated transport team. ECMO transports can be performed safely for all age groups for long distances, probably throughout most of Eu- rope. Keywords ECMO ´ Respiratory failure ´ Transportation ´ Inter- hospital ´ ARDS Intensive Care Med 2001) 27: 1643±1648 DOI 10.1007/s001340101060 NEONATAL AND PEDIATRIC INTENSIVE CARE

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