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ECMO for providers

Referring a patient to ECMO

Infants, children, teens and adults suffering from severe cardio-pulmonary failure and other life-threatening conditions may require the use of extracorporeal membrane oxygenation (ECMO). ECMO is a sophisticated procedure, similar to the heart-lung bypass machine used in cardiac surgery, which takes over the oxygenation and heart function in patients with serious lung disease, cardiac disease, or trauma.

  • For consultation or referral, Legacy One Call Consult & Transfer: 1-800-500-9111
  • Go here for our referral criteria for adults
     

We accept questions and referrals 24 hours a day, seven days a week. We are happy to receive consultations or to arrange transfer from centers in Oregon, Washington and the surrounding regions.

Legacy Emanuel Medical Center/Randall Children's Hospital offers a leading center for ECMO care, and the only center in the region with an ECMO transport team — a mobile ICU with the capability to transport patients to our ECMO care.

A standard of care with solid results

  • We utilize ECMO when indicated as a routine aspect of our protocolized approach to ARDS when other means of oxygenation and/or ventilation are insufficient or less safe.
  • Outcomes are significantly improved with both adult ARDS and H1N1 pneumonia if patients are cared for in an ECMO center.
  • We also use ECMO to support circulation as appropriate for profound shock (septic and cardiogenic), hypothermia or in the extremes of resuscitation.
  • Our survival-to-discharge rate for adults with respiratory failure has been greater than 81 percent. These patients were profoundly hypoxic, with an average PF ratio of 55 on maximal ventilator support. The international norm for a similar cohort of patients is 59 percent.
  • The survival rate for children treated with ECMO at Randall Children’s Hospital has been 75 percent and the VDR ventilator is used to prevent young patients from requiring ECMO and to assist with their recovery on ECMO. 

For more, see ECMO: our history, references.

Transport capabilities

To speed your patients' safe access to potentially lifesaving therapy, we provide the only dedicated and immediately available ECMO transport team in the Pacific Northwest for adults and adolescents. This mobile critical-care team consists of two attending surgeons, a perfusionist, a respiratory therapist, an OR nurse and a trauma resuscitation/ICU nurse.

Recognized for excellence

Legacy's ECMO program has earned the ELSO (Extracorporeal Life Support Organization) Award for Excellence in Life Support. This award signifies that our program has been recognized as a “distinguished leader in critical care" and provides high-quality, state-of-the-art care. 

Information for patients

Patients can read about our ECMO services here; for pediatric ECMO, patients and families can find more information here.

Expert consultation

If you are treating an infant, child or adult suffering from severe cardio-respiratory failure who is not responding to standard medical treatment, the experts at Legacy Emanuel and Randall Children’s Hospital provide collaborative, consultative advice. Our experience with hundreds of ECMO cases shows that early dialogue is crucial to optimal patient survival and outcomes. 

Therapy for serious conditions

Our program helps patients with these conditions:

Neonates

• Meconium Aspiration Syndrome (MAS)
• Pneumonia
• Sepsis
• Respiratory failure
• Congenital diaphragmatic hernia
• Persistent pulmonary hypertension of the newborn (PPHN)
• Congenital heart disease

For infants/children/teens/

• Near drowning
• Pneumonia
• Sepsis
• Congenital heart disease
• Respiratory failure
• Shock
• Traumatic injury
• Acute Respiratory Distress Syndrome (ARDS)
• Acidosis
• Hypoxia
• Hypothermia

For adults

 • Near drowning
• Pneumonia
• Sepsis
• Congenital heart disease
• Respiratory failure
• Shock
• Traumatic injury
• Acute Respiratory Distress Syndrome (ARDS)
• Acidosis
• Hypoxia
• Hypothermia
• Bridge to transplant

In addition to ECMO, we offer a full spectrum of related therapies: advanced ventilator management, kidney support therapy, plasmaphoresis, sophisticated monitoring, imaging and cardiac assist devices. All of these services are under the direction of specially trained, experienced and board-certified neonatal, pediatric and medical and surgical care specialists.

In addition, the PICU at Randall Children's Hospital uses volumeric diffusive respiration (VDR) systems to keep some patients with lung problems from needing ECMO.

Rooms in Randall Children's Hospital in the NICU and PICU are large enough to have room for the ECMO equipment.

For adults, a new critical care unit has been designed for state-of-the art care in a family-oriented setting. Family and friends are welcome to participate while at the bedside of their loved one.

Specialized, dedicated team –– around the clock

Our program features a range of specialists to provide minute-to-minute bedside support for the complex technology.
• ECMO-trained neonatologists and pediatric intensivists are available around the clock in the Neonatal Intensive Care Unit (NICU) and in the Pediatric Intensive Care Unit (PICU).
• Specially trained ECMO physicians work with pediatric surgeons, cardiothoracic surgeons, trauma surgeons, cardiologists, and renal and pulmonary specialists to care for ECMO patients.
• The ECMO nurse specialist operates the ECMO machine, making adjustments. An additional nurse monitors vital signs and other aspects of patient care.
• We have a full team of specialists, perfusionists, therapists and more

ELSO database registry

ELSO maintains an international registry of information about ECMO patients. We submit information on each ECMO patient to this database, which provides us with invaluable information about ECMO therapy, underlying illnesses and patient outcomes. We use this data to evaluate and continually improve our care of the ECMO patient.

Our providers

Ivonne M. Daly, M.D., FACS, medical director, adult ECMO

Andrea Hoogerland, M.D., medical director, pediatric ECMO, Randall Children's Hospital

Peter Quint, M.D., pediatric ECMO liaison

Sandra Wanek, M.D., ECMO surgeon