ECMO / ECLS
(Extracorporeal Membrane Oxygenation / Extracorporeal Life Support)
The Extracorporeal Life Support (ECLS) service in the Mater Hospital provides comprehensive short-term support for adult patients with severe, acute, potentially reversible lung or heart failure. The programme is based in the Intensive Care Unit and the bed-side care is provided by Intensive Care Nursing and Medical staff with specific ECLS training. Our collaborative programme is actively supported by the Departments of Cardiothoracic Surgery, Perfusion, Vascular Surgery, and Cardiology. Extracorporeal Life Support is also known as extracorporeal membrane oxygenation (ECMO) and the terms are used interchangeably.
Short-term extracorporeal support for occasional patients with severe cardiogenic shock after heart surgery has been long established in the Mater Hospital. The Mater ECLS Programme was initiated in 2009 when for the first time in Ireland, prolonged ECLS support was used for an adult patient with primary lung failure.
The Mater ECLS Programme has been formally registered with the Extracorporeal Life Support Organisation (ELSO centre: 185). ELSO is the recognised international organisation for extracorporeal support and is based in University of Michigan, Ann Arbor, USA. In addition to promoting the highest educational standards for extracorporeal practice, ELSO also maintains a worldwide registry of all extracorporeal activity in both adults and children. The Mater ECLS training course is firmly based on ELSO educational guidelines.
The use of ECLS for adult patients with severe lung failure has increased in the past 5 years. A favourable outcome can be anticipated where there is timely patient selection and the technical and clinical expertise is well established in the ECLS centre. Patients with severe hypoxaemia or who develop progressive deterioration in gas exchange or lung compliance despite optimal efforts to apply a 'lung protection' conventional mechanical ventilation strategy should be considered for ECLS. Please see Indications and Contraindications for ECLS. The outcome after ECLS is improved if extracorporeal support is initiated before progression to intractable lung failure (i.e. less than 7 days of high pressure mechanical ventilation).
Patients being considered for ECLS may be already in the Mater Hospital or referred from another hospital. The following guidelines may help to identify patients who may benefit from ECLS.
Please see the following documents.
Mode of ECLS (113 kbs)
Initial Referral Guidelines:
We would appreciate if the initial request for consideration of ECLS could be made through the Mater ICU Senior Registrar: 01 803 2000 Pager: 2281.
Please ensure that the guidelines for Indications and Contraindications for ECLS are noted prior to referring a patient for consideration of ECLS.
If further advice is required regarding medical or nursing issues related to ECLS, please contact the
Patients who may be candidates for ECLS should be transferred to the Mater Hospital as soon as possible using the Mobile Intensive Care Ambulance Service (MICAS). In some cases, members of the Mater ECLS team may attend the referral hospital to assist with the evaluation of the patient for ECLS. If appropriate, ECLS may be initiated prior to transfer back to the Mater ICU. While we are endeavouring to offer a comprehensive ECLS service for all adult patients in Ireland, due to staffing constraints or bed capacity issues, it may not always be possible to immediately accept patients for ECLS.