Complications of ECMO During Transport | PSNet

Complications of ECMO During Transport | PSNet

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Complications of ECMO During Transport

Summary: A 54-year old woman with chronic obstructive pulmonary disease was admitted for chronic respiratory failure. Due to severe hypoxemia, she was intubated, mechanically ventilated and required extracorporeal membrane oxygenation (ECMO). During the hospitalization, she developed clotting problems, which necessitated transfer to the operating room to change one of the ECMO components. On the way back to the intensive care unit, a piece of equipment became snagged on the elevator door and the system alarmed. The perfusionist arrived 30-minutes later and realized that the ECMO machine was introducing room air to the patient’s circulation, leading to air embolism. The patient became severely hypotensive and bradycardic, and despite aggressive attempts at resuscitation, she died. 

The associated commentary discusses the importance of a dedicated ECMO transport team that includes ECMO specialists as well as critical care staff, specific training on managing ECMO-related emergencies for dedicated ECMO and other critical care staff, and how a structured checklist for complex mechanical support can be used for both routine assessment and emergency response.