Inter-hospital transports on extracorporeal membrane oxygenation in different health-care systems

Since 1975 when the very first inter-hospital transfer of a patient on Extracorporeal membrane oxygenation (ECMO), a procedure later described by Bartlett et al. (1), the need for transports have continuously increased. During the following three decades, a limited number of ECMO centers performed transports on ECMO. However, shortly after the onset of the H1N1 pandemic between 2009 and 2010 such transport systems became a necessity. Some countries had the experience and an infra-structure for long distance transports of intensive care patients, but less experience of transports on ECMO (2). In a short timeframe emergency hospitals and intensive care departments had to organize and establish routines for transfers of patient on ECMO. The international experience suggested transports on ECMO to be safer as compared to a transfer of an unstable refractory respiratory failure patient supported with conventional ventilation (3,4). At that time information and support was to be found at centers that already had well developed ECMO transport organizations and years of experience from more than 100 transports (5-8). Today the Extracorporeal Life Support Organization (ELSO), publish guidelines that are updated regularly (9)