Evidence note 30
Extracorporeal membrane oxygenation (ECMO) for respiratory
support in adults
Background
Extracorporeal membrane oxygenation (ECMO) technology provides
temporary life support to patients with severe life threatening but
potentially reversible cardiac or respiratory failure. It involves
removing blood from the patient’s venous circulation and passing it
through an external membrane lung where oxygen is added and CO2 is
removed before it is returned to the patient’s circulation.
Respiratory support
ECMO
for adults in
Scotland is currently available through the United Kingdom (UK)
national
ECMO
centre at
Glenfield Hospital in Leicester and the accredited European centre
at the Karolinska Hospital in Stockholm.
Key messages
- In a randomised controlled trial (CESAR) conducted by the UK
national
ECMO
centre, referral
for consideration of
ECMO
was associated
with a statistically significant reduction in the risk of death or
severe disability at 6 months compared with conventional management
in a tertiary intensive care unit.
- There are few published data on long-term outcomes following
ECMO
for
respiratory failure in adults.
- The additional average health care cost per patient referred
for
ECMO
in the CESAR trial was more than double the average cost of
conventional management. The estimated cost per additional QALY was
£1,631,124.
- Robust cost effectiveness models need to be constructed
locally.
- Due to its complexity and potential complications
ECMO
should only be
provided in specialist centres.
A Scottish Health Technologies Group publication
This Evidence Note was commissioned by the National Planning
Forum, via the Scottish Health Technologies Group, to inform the
work of
ECMO
Expert Group set
up by the Cabinet Secretary for Health and Wellbeing to evaluate
the need for medium and long term provision of
ECMO
for adults in
Scotland. The
ECMO
Expert Group
report is available from the Scottish Government website http://www.scotland.gov.uk/Publications/2010/04/16151905/0
The content of this evidence
note was accurate and based upon the most up to date evidence
available at the date of first publication. Readers are asked to
consider that new trials and technologies may have emerged since
first publication and the evidence presented may no longer be
current.
Published Date: 01 November 2010
