The use of Extracorporeal Membrane Oxygenation (ECMO) therapy has increased in recent years, after the COVID pandemic, as hospitals and clinicians have realized its growing value as a life-saving therapy with multiple new and emerging use cases. As testament to this growth, according to Future Market Insights the global ECMO machine market is currently valued at $582 million, and is poised to grow to $904 million in the next 10 years.

Innovations in ECMO technology are making it safer and easier to perform ECMO, as well as to transport ECMO to remote or rural areas, or to use in emergency situations. Increased utilization is offering some patients a new lease on life, which perpetuates the expansion of ECMO use cases and its adoption in more facilities. The use of ECMO has, since COVID, been particularly helpful in reducing mortality in pediatric and neonatal patients. 

Pros and Cons of ECMO Programs

Because ECMO technology is evolving to become safer and easier to use, and offering increasing chances of recovery for very vulnerable or critically ill patients, ECMO programs are becoming a more attractive prospect for hospitals and specialized care facilities. Strong ECMO programs allow hospitals to serve more patients, improve patient outcomes, strengthen reputations for patient care and expertise, and grow revenue from strong ROI strategies and reimbursements. 

But beginning a new ECMO program can bring challenges as well, which is why it’s important to weigh the advantages and disadvantages prior to embarking on the launch of a program. Certainly, creating an ECMO program can be a costly endeavor, given the expense of the equipment and disposables, new personnel, specialized training, and more. But revenue opportunity typically can be a convincing factor in moving ahead, as can a trusted partnership with an ECMO services provider who can collaborate and guide on program start-up and growth over time. 

Here are three specific considerations that should impact the choice to begin an ECMO in today’s hospitals:

1. ECMO must be viewed as more than just a last-resort therapy. As a last resort therapy, patients may be given only a temporary lifeline, with no real opportunity for recovery. The Advisory Board cites cases where ECMO has become a “bridge to nowhere” for some critically ill patients, resulting in tough decisions for clinicians and families and perhaps prolonged suffering for the patient. However, the miraculous recovery of other patients speaks to ECMO’s potential to save those who otherwise would have certainly died. It is important for hospitals and clinicians to work collaboratively to select patients who can truly benefit from ECMO therapies, and to monitor those patients carefully to ensure ideal time on treatment and, ultimately, their positive outcomes.

2. There must be a strong commitment to team training and experience building. Inexperience or human error can have an outsized effect on patients when it comes to ECMO. The Journal of Artificial Organs reports that in a review of patient safety accidents involving ECMO, nearly half resulted in death or residual disability, and the most common errors were related to cannula malposition and decannulation. It recommended training for cannulation techniques and that hospitals offering ECMO should also perform emergency surgeries.
   
   Running a successful ECMO program requires a trained and experienced team, and ELSO recommends standardized ECMO education and certification to achieve optimal patient care. Hospitals should work with an ECMO partner focused on team training, education and certification through ELSO.

3. Case volume expectations must be realistic: low ECMO case volumes can mean higher mortality rates. The American Journal of Respiratory and Critical Care Medicine reported that in a study of over 50,000 ECMO patients across roughly 20 years, hospitals with fewer than 30 adult ECMO cases annually had “significantly lower odds of mortality” than those with six or fewer adult cases. This means that multidisciplinary ECMO teams need regular experience and practice to be able to perform at their best. Additionally, The Advisory Board states, “Limited volumes jeopardize ECMO program quality and financial feasibility.”
   
   A strong ECMO partner can analyze the current ECMO opportunity in a particular hospital or specialized care facility, and build realistic expectations for program growth and success over time.

The advantages of an ECMO program are clear; the utilization of ECMO can make surgery safer and provide life-saving therapy to patients of all ages who are undergoing significant cardiac or respiratory issues. For some patients, all they need is a little more time and the chance to rest from the acuity of their condition. This can give clinicians a greater ability to provide treatment and more confidence in decision-making. 

The bottom line is that hospitals or facilities looking to start ECMO programs should first count the costs, confirming financial viability and ensuring that top-tier training, protocols, and communication are employed for the greatest level of success. Programs should also regularly report outcomes and measure performance in order to guarantee improvement. 

We Can Help You with ECMO

At SpecialtyCare, we can provide you with highly trained ECMO professionals who can integrate seamlessly into your OR and ICU to provide life-saving treatment when required. They have the experience and knowledge that you need to start or sustain an ECMO program. We also provide assessments, consulting, and coordinators who can help you set up a program so that it upholds standards of care and has clear oversight. We would love to help you utilize ECMO therapy so that you can take advantage of its capabilities and help more patients. Contact us today to learn more.