ECMO stands for extra-corporeal membrane oxygenation. It is a form of life-support that we offer to patients with the most severe forms of heart and lung failure.
Royal Papworth Hospital is commissioned by the National Specialised Commissioning Team to provide ECMO to patients with Acute Respiratory Distress Syndrome (ARDS). Royal Papworth is one of only five centres in the country to offer this service, alongside partners in Manchester, Leicester and two in London.
We support the East Anglia region and parts of north London, regularly retrieving patients from hospitals across this region 24 hours a day. This specialist retrieval team is available to go and rapidly stabilise and retrieve patients referred to the service, as well as offering advice and support.
This is part of a co-ordinated national response service to ensure all patients have year-round access to ECMO in England.
What is ECMO?
ECMO is a technique that oxygenates blood outside the body. It can be used in potentially reversible severe respiratory failure when conventional ventilation is unable to oxygenate the blood adequately. The aim of ECMO in respiratory failure is to allow the injured lung to recover whilst avoiding certain recognised complications associated with conventional ventilation. It is high risk and is therefore only used as a matter of last resort in difficult cases. The procedure involves removing blood from the patient, taking steps to avoid clots forming in the blood, adding oxygen to the blood and pumping it artificially to support the lungs.
ECMO is a highly specialised technique, which needs the input of intensive care specialists, cardiothoracic surgeons as well as ECMO-trained nurses and perfusion scientists.
An ECMO machine at Royal Papworth Hospital
The ECMO service at Royal Papworth Hospital
As a tertiary cardiothoracic centre, Royal Papworth Hospital has been providing specialist ECMO services for a number of years. The hospital is registered with the international ExtraCorporeal Life Support Organisation (ELSO) and is renowned for its experience using ECMO for either cardiac or respiratory support.
In addition to providing ECMO on site, Royal Papworth Hospital has developed a retrieval service to secure the rapid and safe transfer of patients between referring hospital and the ECMO centres. The hospital provides the ECMO service to patients in Cambridgeshire, Norfolk, Suffolk, Hertfordshire, Bedfordshire, Essex and North East London. Based on modelling by the National Specialist Commissioning Team, Royal Papworth will receive around 30 patients each year but retains the flexibility to increase capacity in response to higher demand.
The hospital will support the national service by accepting patients from the other centres if they reach full capacity.
ECMO during COVID-19
The number of ECMO patients across the UK surged dramatically during the height of the coronavirus pandemic. Usually at Royal Papworth Hospital we have three respiratory ECMO patients at any one time, with approximately 15 across the five centres. In April 2020 our ECMO service peaked at 21 patients with up to 90 nationally, caring for the most critically ill patients who were in respiratory failure and for whom a ventilator was no longer effective.
Find out more about how our ECMO team is meeting the increased demand caused by COVID-19.
ECMO training opportunities
Royal Papworth Hospital runs a multidisciplinary and comprehensive course on all aspects of new ECMO in the adult patient. The ECMO course is aimed at medical staff, experienced nurses, and perfusionists.
To refer a patient to Royal Papworth's ECMO service, please use the new national online ECMO referral system available here.
This new system will help us coordinate the national response to the COVID-19 pandemic. The National ECMO Service is implementing this eReferral system known as ‘referapatient’ commissioned by NHS England. This includes referral pathways for all patients with acute severe respiratory failure who may need ECMO, including those with COVID-19.
If your referral is an emergency and you need to contact us after submitting your online referral call our switchboard on 01223 638000 and ask to speak to our ECMO co-ordinator. If you are experiencing problems with the online referral call 01223 638000 directly.