Global Survey of Extracorporeal Membrane Oxygenation Transport Programs: Variability in Team Composition, Training, and Capabilities

Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary support associated with improved survival in severe respiratory failure and refractory cardiac arrest. Extracorporeal membrane oxygenation is highly specialized and resource-intensive; high-volume ECMO centers demonstrate improved outcomes, supporting the creation of regionalized care models. As such, the role of critical care transport medicine (CCTM) is vital. Given limited prior analysis, we aimed to descriptively review ECMO transport processes globally. A 27 item survey addressing team composition, training, and transport capabilities was distributed to 16 transport organizations in eight countries. If available, ECMO transport protocols were reviewed. Fourteen ECMO programs responded from six countries (87.5% response rate). Most programs (78.6%) offer ground, 71.4% offer rotary-wing, and 50% offer fixed-wing transport. A minority (28.6%) provided all transport modes. Nearly half (42.9%) of programs did not require a separate ECMO team. A physician was present in 57.1% and a perfusionist/ECMO specialists in 71.4% of transport teams, respectively. All programs required initial team ECMO training. Critical care transport medicine teams are essential for enabling ECMO access. There is significant variability in team composition, capabilities, and transport modality, but training requirements are seen across programs. Further study should align best practices for interfacility transport of ECMO patients.