Extracorporeal Membrane Oxygenation (ECMO) can provide cardiac or respiratory (or both cardiac and respiratory support) in critically ill patients.  It is a highly specialised form of ICU management.  The Alfred ICU has provided ECMO care since 1990 and has now performed ECMO on more than 500 patients.  The Alfred ICU is the state service provider for ECMO retrievals.

ECMO Clinical Service

An ECMO Clinical Service, independent from Perfusion Services, was established in 2003 to improve ECMO delivery and beside care.  The philosophy of the ECMO Clinical Service is that ECMO is best provided as an integrated Intensive Care patient support modality. Training programs, competency maintenance, credentialing requirements, protocols, preventative strategies and consultative Perfusion Service input are components of our integrated ECMO Service.

Our expertise, training and excellent patient outcomes culminated in 2013 with ELSO awarding the Alfred ICU “Centre of Excellence in Life Support”, the only such centre in this region.

ECMO at The Alfred  (400 kb pdf)

 
ECMO Referrals

The Alfred ICU runs a comprehensive ECMO retrieval service in conjunction with Adult Retrieval Victoria (ARV).  If you have a patient you believe will benefit from ECMO please contact us at the earliest available opportunity.  We have 24hour Consultant availability for patient discussion, referral and retrieval. 

Please refer to our ECMO inclusion and exclusion criteria

In order to expedite the referral process, please complete the Critical Patient Referral Form .  It contains most of the information the ICU Consultant will request at the time of the initial referral.  After the first referral has been made the ICU Consultant will arrange for a Case Conference with the ARV team where appropriate - this will involve the referring physician, the Alfred ICU retrieval team, the ARV co-ordinator and the ARV retrieval team.

If possible, we try to retrieve patients in daylight hours to optimise patient safety.  However, please do not delay referrals until daylight hours.

When the retrieval team arrives at your centre they will bring all the specialised equipment required.  Some more standard items will need to be provided - please ensure that the items listed here are available when the team arrive.

ECMO Education

We run a world renowned twice yearly Adult ECMO Course .  This course has been designed for doctors, nurses and perfusionists seeking to provide ECMO support to patients with severe forms of cardiac and respiratory failure.  It is designed for participants with little prior experience in the provision of ECMO.  All aspects of care required by these patients are addressed.

Participants are provided with copies of Alfred Hospital educational, protocol and point-of-care resource to adapt for use in their own centres. This information is provided to candidates at the course and there is no pre reading required.

There is an associated Alfred ECMO Cannulation Training Course that provides the opportunity for medical practitioners to learn the practical manual skills for performing percutaneous ECMO cannulation.

Every two years, we hold an International ECMO / VAD symposium that features all the recent developments and controversies in these areas.

We also run extensive in-house ECMO training and accreditation for our junior medical and nursing staff.  Many of the educational resources are available on our INTENSIVE  website - an online education and knowledge translation resource.

 Observerships in our department are also available. Read More

ECMO Research Service

There is an active program of ECMO Research at The Alfred - including local studies and international collaborations.  We are a foundation site member of the ECMOnet (International ECMO Network) which aims to foster collaborative research across international centres.

Current projects include:

HELP-ECMO
Heparin Low dose Protocol in ECMO patients

EOLIA - ECMO tO rescue Lung Injury in severe ARDS
A multi centre randomized controlled trial of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome. The primary endpoint is 60 day mortality.

The EOLIA Quality of Life Study (EOLIA QoL) (funded by the Intensive Care Foundation)
This study will investigate the effect of ECMO on long term disability in critically ill patients with severe acute respiratory distress syndrome. The primary outcome is quality of life as measured using the SF36 and EQ5D at 6 and 12 months post randomization.

The first clinical trial of a bidirectional arterial cannula for peripheral VA ECMO will be commencing in 2016.

We have published  extensively on our clinical ECMO experience.