ECMO Program at Providence Hospital

Extracorporeal Membrane Oxygenation (ECMO) is an advanced, temporary life support for patients with severe, potentially reversible heart or lung failure.

Refer a Patient

About the ECMO Program

As one of the few institutions on the Gulf Coast equipped to provide ECMO, USA Health delivers rapid access to this critical therapy through a highly trained multidisciplinary team and a streamlined referral and transfer process—eliminating the need for out-of-region transport, saving valuable time, and allowing patients and families to receive the highest level of care close to home.

What Is ECMO?

ECMO (Extracorporeal Membrane Oxygenation) is a form of advanced life support that temporarily takes over the work of the heart and/or lungs. Blood is circulated outside the body through a pump and oxygenator, which adds oxygen and removes carbon dioxide before returning the blood to the patient.

ECMO does not treat the underlying disease; rather, it provides critical support while the heart or lungs recover, or serves as a bridge to transplant or other definitive therapies.

Types of ECMO

Veno-Venous (VV) ECMO: Supports lung function only; used for severe respiratory failure.
Veno-Arterial (VA) ECMO: Supports both heart and lung function; used for cardiogenic shock, cardiac arrest, or combined heart and lung failure.

Cardiac Conditions
Supported by ECMO

Cardiogenic shock
Acute myocardial infarction (heart attack)
Cardiomyopathy
Myocarditis
Failure to wean from cardiopulmonary bypass
Severe hypothermia
Sepsis

Pulmonary Conditions
Supported by ECMO

Acute Respiratory Distress Syndrome (ARDS)
Severe respiratory failure
Pulmonary embolism
COVID-19
Influenza and severe pneumonia
Pulmonary hypertension
Trauma
Anaphylaxis

ECMO Care Team

ECMO care at USA Health Providence Hospital is delivered by a coordinated, ECMO-trained multidisciplinary team available 24/7, including:

Cardiothoracic surgeons and ECMO cannulation team
Critical care physicians (adult intensivists)
Cardiologists (as indicated)
Perfusionists and ECMO specialists
ECMO-trained ICU nurses
Respiratory therapists
Pharmacists
Nurse practitioners and physician assistants
Physical and occupational therapists
Nutrition services
Social work, case management, and palliative care
Infection prevention and laboratory services

The team meets daily to reassess care plans and outcomes and is available around the clock for emergent cannulation, consultation, and transfer coordination.

When to Refer a Patient

Respiratory Indications (VV ECMO)

Severe hypoxemic respiratory failure (e.g., PaO₂/FiO₂ < 80) despite optimal ventilation, paralysis, and prone positioning
Refractory hypercapnia with acidosis
Respiratory failure expected to be reversible or as a bridge to transplant

Cardiac Indications (VA ECMO)

Refractory cardiogenic shock despite inotropes and vasopressors
Postcardiotomy shock or failure to wean from bypass
Cardiac arrest with potential for recovery (ECPR)

Additional Considerations

Severe pulmonary embolism with hemodynamic compromise
Bridge to decision for transplant or durable mechanical circulatory support

ECMO is generally not appropriate for patients with irreversible multi-organ failure, uncorrectable bleeding disorders, or severe neurologic injury incompatible with meaningful recovery. Final decisions are guided by multidisciplinary clinical judgment.

How to Refer a Patient

USA Health Providence maintains a rapid, standardized ECMO referral and transfer pathway to minimize delays:

Immediate consult (24/7)
Call the ECMO Transfer Center at 1-833-USA-STAT. For emergent cases, state: “ECMO activation — emergent cannulation.”
Provide a brief clinical summary
Diagnosis, age, ventilator settings, ABGs, hemodynamics, vasoactive support, labs, and imaging.
Team assessment
The ECMO team will advise on stabilization, eligibility, and transfer timing, and can provide real-time guidance.
Transfer coordination
Transport by ground or air is arranged as needed. On-site cannulation may be discussed for unstable patients when available.

If you are unsure whether ECMO is appropriate, call the consult line. Early discussion is encouraged. The consult line is answered 24 hours a day, 7 days a week. Be prepared to provide all necessary patient information, including diagnosis, reason for transfer, and your contact details as the referring physician.

Frequently Asked Questions

What are the risks and considerations?
ECMO can be lifesaving but carries significant risks, including bleeding, infection, kidney failure, limb ischemia, stroke or brain injury, circuit clotting, and death. Patients are closely monitored to minimize complications, and care plans are reassessed daily.

How long do patients remain on ECMO?
Duration varies from days to weeks, depending on the underlying condition and recovery.

Is ECMO a cure?
No. ECMO is a supportive therapy that allows time for recovery or transition to definitive treatment.

Can families be involved in care?
Yes. Family communication and support are integral, with social work and palliative care available.

Is ECMO available for pediatric patients?
No. At this time, this service is only for adult patients.

Will insurance cover ECMO?
Coverage varies by payer. Case management and financial counselors assist with authorization.

What happens after ECMO?
Patients remain in the ICU for recovery and rehabilitation and may require additional therapies or long-term follow-up.

Funding Acknowledgment: This project is funded in part by the State and Local Fiscal Recovery Funds (SLFRF) program under the American Rescue Plan Act (ARPA), administered by the Mobile County Commission.