About ACH ECMO Transport
Among the national and international ECMO centers, ACH has one of the largest experiences to offer air transport of critically ill patients on an ECMO circuit. Mobile ECMO features include:
- Helicopter Transport (two Sikorsky S-76 C+ aircraft)
- Jet Transport (ACH has fixed-wing aircraft available for longer distances through local vendors)
- Ground Ambulance (three ground ambulances include the ability to transport two isolettes, Mobile ECMO and more)
For ECMO support referrals, call Angel One Dispatch at 1-800-ACH-HELP. Ask to speak to the pediatric intensivist, cardiac intensivist or neonatologist on call, depending on the age of the child and primary problem.
ECMO Selection Criteria
The need to escalate to ECMO support can be a difficult decision for a referring physician. Arkansas Children’s Hospital has developed selection criteria to help guide you through this process. The decision to transfer to an ECMO center begins with early consultation to allow for logistics for transport. We hope the following information will help answer some of the questions your team may have. For an ECMO transport call 1-800-ACH-HELP.
- Birth weight > 1.8 kg
- Gestational age > 34 weeks
- No major bleeding problems
- Less than 10 days mechanical ventilation
- Normal head ultrasound of if IVH present it must not be > than grade 1 hemorrhage.
- No Coagulopathy
- Disease process that is felt to be reversible.
- Oxygen index ( OI ) of > 40 for more than 2 hours. (OI=Mean airway pressure x Fio2 x 100/PaO2)
The pediatric ECMO criteria have no hard set criteria, but here are some things to consider.
- No major bleeding problems
- No multi-organ failure
- Less than 7 to 14 days on high mechanical or high-frequency ventilator settings.
- 1 month to 18 years of age
- Acute respiratory failure
- Near drowning
- Status asthmaticus
- Other reversible lung disease
This is the most difficult population to give criteria for, the decision to place a pediatric cardiac patient on ECMO involves many factors. Echocardiography and Cath labs are great tools to help in this decision process, but we understand many centers may not have access to this equipment.
The following is a general list of the different type of cardiac patients that may be placed on ECMO support.
- Post cardiac arrest
- Cardiogenic shock
- Cardiac failure post heart surgery
- Pulmonary hypertension
- Congenital heart defects pre or post-surgical with chance of survival
- Bridge to transplant
- Bridge to LVAD or other mechanical device.
ACH Verified as Level 1 Children’s Surgery Center
At Arkansas Children’s we understand that surgery can be frightening for you and your child. Our goal is to make your child’s visit as safe, convenient and as comfortable as possible. Our team of highly qualified surgeons take a family-centered approach to care, so you are informed of what to expect before, during and after surgery. Recognized by the American College of Surgeons, our Level I verification represents the highest level of recognition for hospitals that perform complex surgical procedures in newborns and children.