Mobile Extracorporeal Membrane Oxygenation Teams: The North American Versus the European Experience

• Published in: Journal of cardiothoracic and vascular anesthesia 2016-12, Vol.30 (6), p.1441-1448
• Main Authors: Nwozuzu, Adambeke, MD, Fontes, Manuel L., MD, Schonberger, Robert B., MD, MHS
• Format: Article
• Language: English
• Subjects: Anesthesia & Perioperative Care; anesthesiology; Anesthesiology - organization & administration; Critical Care; Europe; Extracorporeal Membrane Oxygenation; Humans; mobile ECMO; North America; Patient Care Team - organization & administration; Patient Transfer - organization & administration; Retrospective Studies
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2016.06.005

Objective To evaluate differences in the inclusion of anesthesiologists in mobile extracorporeal membrane oxygenation (ECMO) teams between North American and European centers. Design A retrospective review of North American versus European mobile ECMO teams. The search terms used to identify relevant articles were the following: “extracorporeal membrane transport,” “mobile ECMO,” and “interhospital transport.” Setting MEDLINE review of articles. Participants None. Interventions None. Results Between 1986 and 2015, 25 articles were published that reported the personnel makeup of mobile ECMO teams in North America and Europe: 6 from North American centers and 19 from European centers. The included articles reported a total of 1,329 cases: 389 (29%) adult-only cohorts and 940 (71%) mixed-age cohorts. Among North American studies, 0 of 6 (0%) reported the presence of an anesthesiologist on the mobile ECMO team in contrast to European studies, in which 10 of 19 (53%) reported the inclusion of an anesthesiologist (Fisher exact p for difference = 0.05). In terms of number of cases, this discrepancy translated to 543 total cases in North America (all without an anesthesiologist) and 499 cases in Europe (37%) including an anesthesiologist on the team (Fisher exact p for difference