Outcomes of extracorporeal membrane oxygenation-assisted interhospital transport of critically ill cardiopulmonary failure patients: a cohort study

Extracorporeal membrane oxygenation (ECMO) is used to provide support for patients with cardiopulmonary failure. Best available medical management strategies often fail in these patients, and referring hospitals have no further recourse for escalating care apart from transfer to a tertiary facility. In severely unstable patients, the only option is to use ECMO to facilitate safe transport. The present study aimed to examine the safety and outcomes of patients transported while receiving ECMO. Statistical analysis was performed on retrospectively gathered data from the electronic medical records of adult patients transported while receiving ECMO to Dongguan People’s Hospital between January 2021 and December 2024. A retrospective review of our four-year institutional experience identified 33 patients transported on ECMO and 75 patients cannulated at Dongguan People’s Hospital. No death occurred during transport. Short- and long-term survival did not differ significantly between the cohorts. In a sensitivity analysis using 1:1 propensity score matching, 26 matched pairs were obtained; 28-day mortality (38.5% vs. 34.6%, p = 0.77) and one-year mortality (57.7% vs. 50.0%, p = 0.58) remained comparable between transported and in-house patients. Owing to the small number of outcome events, the regression analyses should be considered exploratory. In this single-center retrospective cohort, interhospital transport of selected patients receiving venovenous or venoarterial ECMO was feasible and occurred without transport-related mortality. Comparable survival between transported and in-house patients should be interpreted cautiously and confirmed in larger prospective multicenter studies.