Cleveland Clinic ECMO Program

Cleveland Clinic ECMO Program
Name	Cleveland Clinic ECMO Program
Location	Cleveland, Ohio
Country	United States
Healthcare	Private
Type	Tertiary care
Specialty	Extracorporeal membrane oxygenation
Founded	1980s

Cleveland Clinic ECMO Program is a major extracorporeal membrane oxygenation service based at a tertiary care medical center in Cleveland, Ohio, within a large integrated health system. The program provides venoarterial and venovenous support for adults and pediatrics, coordinating referrals from regional hospitals and collaborating with national networks during public health emergencies. It integrates multidisciplinary teams from cardiothoracic surgery, Anesthesiology, Pulmonology, Intensive care medicine, and Cardiology to deliver advanced cardiopulmonary support.

Overview

The program offers advanced life support modalities including venoarterial ECMO and venovenous ECMO, bridging to recovery, transplant, or durable mechanical circulatory support such as left ventricular assist device therapies. It operates within an academic center that houses specialties like Heart transplantation, Lung transplantation, Cardiac surgery, and Critical care medicine, enabling complex case management and rapid escalation of care. The service collaborates with regional transfer centers, Emergency medical services, and national registries to optimize patient selection and outcomes.

History and Development

Established in the late 20th century amid advances in extracorporeal circulation, the program expanded through milestones in cardiopulmonary bypass technology, innovations from departments including Cardiothoracic surgery and Biomedical engineering, and participation in multicenter trials alongside institutions such as Mayo Clinic and Johns Hopkins Hospital. During the H1N1 influenza pandemic and the COVID-19 pandemic, the program scaled capacity and contributed to consortium efforts with entities like the Centers for Disease Control and Prevention, regional referral networks, and national ECMO registries. Collaborative initiatives with manufacturers and research centers advanced protocols for anticoagulation management, cannulation techniques, and portable ECMO transport used in Air medical services.

Clinical Services and Indications

Clinical indications managed include refractory respiratory failure, cardiogenic shock after myocardial infarction, post-cardiotomy failure, and bridge-to-transplant scenarios for patients referred from community centers. The service treats adult and pediatric populations, coordinating with Neonatology for neonatal respiratory failure and with Pediatric cardiology for congenital heart disease. It offers mobile ECMO retrieval teams for interfacility transport and provides perioperative ECMO for high-risk procedures in coordination with Anesthesiology, Cardiac surgery, and Thoracic surgery teams.

Program Structure and Staffing

The program is staffed by multidisciplinary teams composed of Cardiothoracic surgeons, Critical care physicians, Perfusionists, Respiratory therapists, Nurse practitioners, and specialized ECMO nurses. Administrative oversight aligns with the institution’s departments such as Critical Care Medicine, Cardiac Surgery Department, and Transplant Center. Governance includes program leadership, quality committees, and collaboration with hospital systems like Integrated health networks to manage referrals, bed allocation, and resource utilization during surge events.

Outcomes and Research

Outcomes reporting is informed by participation in registries and collaborations with academic partners including Cleveland Clinic Lerner College of Medicine, multicenter consortia, and device manufacturers. Published work has addressed survival metrics for venovenous and venoarterial ECMO, complications such as bleeding and thromboembolism, and strategies for weaning and transplant candidacy in patients with severe Acute respiratory distress syndrome. Research collaborations have linked the program with investigators from institutions like University of Pittsburgh Medical Center, Massachusetts General Hospital, and Vanderbilt University Medical Center to study biomarkers, anticoagulation protocols, and device innovation.

Training, Education, and Simulation

The program provides formal training pathways for fellows in Cardiothoracic surgery residency programs, Critical care fellowships, and allied health staff, offering simulation-based education using high-fidelity manikins and bench models. Educational activities include grand rounds, multidisciplinary case conferences, and hands-on workshops in collaboration with professional societies such as the Extracorporeal Life Support Organization, American College of Cardiology, and Society of Thoracic Surgeons. Partnerships with academic departments and continuing medical education providers support certification and competency assessment.

Quality Assurance and Patient Safety

Quality programs emphasize standardized protocols for cannulation, anticoagulation, infection control, and ventilator management, overseen by institutional safety committees and accreditation bodies. The program participates in peer review, morbidity and mortality conferences, and national benchmarking through the Extracorporeal Life Support Organization registry and other specialty registries. Continuous improvement initiatives coordinate with hospital risk management, Infection Control, and patient-family advisory councils to reduce complications, optimize resource use during crises, and improve long-term functional outcomes.

Category:Extracorporeal membrane oxygenation Category:Hospitals in Cleveland Category:Cleveland Clinic