ID:144 FC-D08-6 A Study on Office Hour vs. Out of Office Hour ECMO Cannulation on Clinical Outcomes: Single Center Experience

Background: Extracorporeal membrane oxygenation (ECMO) is a lifesaving but resource-intensive therapy for severe respiratory and/or cardiovascular failure. Both patient and mechanical complications contribute substantially to morbidity and mortality. In centers without a 24/7 in-house ECMO team, out-of-office-hours cannulation may involve delayed mobilization and limited personnel availability, potentially affecting outcomes. We evaluated whether cannulation timing (office hours vs out-of-office hours) influences clinical outcomes in real-world tertiary-care setting in Thailand. Methods: We conducted a retrospective single-center cohort study of all veno-arterial (VA) and veno-venous (VV) ECMO runs from January 1, 2023, to December 31, 2024. Cases were categorized by cannulation timing into office-hours and out-of-office-hours groups. The primary outcome was 30-day mortality. Secondary outcomes included survival to decannulation (≥24 hours), survival to hospital discharge, patient and mechanical complications, ECMO duration, and length of stay. Comparative analyses were performed between groups. Results: Forty-three ECMO runs were included. Mean age was 58 years (office-hours) and 60 years (out-of-office-hours), with male proportions of 62% and 63%, respectively. Baseline characteristics were comparable. No significant differences were observed in 30-day mortality or secondary outcomes. Conclusions: In this single-center experience without a 24/7 in-house ECMO team, out-of-office-hours cannulation was not associated with inferior clinical outcomes. Further prospective study is required to determine whether out-hour ECMO initiation impact clinical outcomes.