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ECMO Referrals and Transfers

We are excited to introduce the Straub Benioff Medical Center ECMO program, a specialized service that exemplifies our commitment to excellence. While the decision to transfer care can be clinically challenging, early consultation and collaboration with our ECMO Team is the best way to optimize patient outcomes.

With cutting-edge technology and a dedicated team of ECMO experts, we aim to provide the best possible care, ensuring every patient receives the attention and treatment they deserve. At Straub Benioff, we believe in making a positive impact on patient outcomes; our ECMO program is just one way we strive to achieve that goal.

Conditions We Treat

ECMO support may be utilized in several disease states, such as:

    • Severe Acute Respiratory Distress Syndrome (ARDS)
    • Aspiration pneumonia
    • Pneumonia (viral, bacterial, atypical)
    • Status asthmaticus
    • Acute pulmonary embolism
    • Pulmonary contusion
    • Burn and Inhalation Injury
    • Cardiogenic shock
    • Acute myocardial infarction
    • Refractory arrhythmias
    • Myocarditis
    • Postpartum cardiomyopathy
    • Acute toxicology
    • Procedural ECMO support

ECMO Referral Process and Criteria

ECMO is a potentially lifesaving intervention that requires prompt implementation. If you believe our services can be utilized to optimize your patient, please call 808-304-2212 and request an ECMO consult. You will be connected to the ECMO intensivist to discuss the patient. If the patient is deemed a potential ECMO candidate, transfer to Straub Benioff Medical Center may be offered.

In certain select cases, remote ECMO cannulation and retrieval to Straub Benioff Medical Center may be offered. If you are unsure of how we are able to help, please refer to the criteria below.

Mobile ECMO Transport and Retrieval Service

Some patients are too ill for transport to our center using conventional life support. In this case, using various transportation methods, our mobile ECMO team may place patients on ECMO at other hospitals and transport them back to Straub Benioff Medical Center.

Straub Benioff Medical Center is only center in Hawaiʻi that provides mobile ECMO support. The program is led by Dr. Makoto Uchiyama, DO and our ECMO Coordinator, Paul Patterson, RN.

Adult ECMO Retrieval Process and Patient Preparation

When the mobile team arrives, they may initiate ECMO at your institution. Please review the patient preparation checklist in advance of their arrival.

What to Expect

Two large cannulas are inserted percutaneously using the Seldinger technique. For Veno-venous (VV) ECMO, we insert one drainage cannula in a femoral vein and one return cannula in the right internal jugular vein. For Veno-arterial (VA) ECMO, we insert one drainage cannula in a femoral vein and one return cannula in the femoral artery. A distal perfusion cannula is usually inserted in the superficial femoral artery on the same side.

Cannulation takes up to 60 minutes and is carried out in the Intensive care unit with TEE/TTE guidance. After cannulation, the oxygen saturation and MAP will increase. Once the patient is stabilized, the patient is transported to Straub Benioff Medical Center. If complications occur, or the patient becomes unstable, we may remain in your facility for few hours before departure.

Our ECMO Team

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ECMO

Nurses
Our trained and certified ECMO specialist nurses provide continuous and ongoing care to all patients requiring ECMO support.

Respiratory Therapists
Our respiratory therapists maintain pulmonary care and ventilatory support if a patient is supported with mechanical ventilation.

Perfusionists
Our perfusionists assist with ECMO cannulation, initiation of support and are available 24/7 for consultation and troubleshooting ECMO support.

ICU Attending Physicians
Our ICU attending physicians are board certified in pulmonary and critical care medicine and are responsible for the overall care of all ICU patients.

ECMO Attending Physicians
Our ECMO physicians are board certified in pulmonary and critical care medicine. The ECMO attending evaluates new ECMO patients and participates in the management of all patients being treated with ECMO.

Cardiothoracic Surgeons
Our cardiothoracic surgeons participate in the evaluation of potential ECMO candidates, perform cannulation and decannulation procedures, and participate in the daily management of all patients on ECMO support.

Social Workers
Our social workers provide psychosocial support, counseling and crisis intervention to the patient’s family in relation to their ICU admission and need for ECMO support. They coordinate additional ancillary support services and work with the clinical team and the patient’s family to coordinate possible mainland transfers or hospital discharge.

Physical Therapists
Our physical therapists work with ECMO patients to help prevent and overcome the deconditioning that is commonly associated with critical illness.

ECMO Program Coordinator
Our ECMO program coordinator oversees the Adult ECMO Program and works with the entire ECMO team, patients and families to ensure high-quality care, continuous improvement and the long-term success of the program.

Recognized Excellence in Extracorporeal Life Support

The Straub Benioff ECMO program is designated as an Extracorporeal Life Support Organization (ELSO) Gold Center of Excellence. The ELSO Gold award recognizes extraordinary achievement in the following 3 categories:

  1. Excellence in promoting the mission, activities, and vision of ELSO
  2. Excellence in patient care by using the highest quality measures, processes, and structures based upon evidence; and
  3. Excellence in training, education, collaboration, and communication supporting ELSO guidelines that contributes to a healing environment for families, patients and staff
Medallion for Center of Excellence in Life Support.

Straub Benioff Medical Center
Adult ECMO Program

If you are a physician, please contact to discuss possible patient transfer.

Phone: 808-304-2212
Paul.Patterson@Straub.net