Nurse-led initiative : building blocks of an extracorporeal membrane oxygenation (ECMO)‎ program at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Abstract EN

Background: The mission of the King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, is to provide safe and effective care to patients.

KFSH&RC is a 985-bed hospital that started its ECMO program in 2004.

Based on the ELSO guidelines, KFSH&RC invested in establishing a successful ECMO program by upgrading the logistic, team composition, quality, and educational structure in the organization.1 Methods: The following key components were utilized including institutional commitment, to build a strong program block by block relying on the support of the following team structure: physician champion, multidisciplinary leadership, nursing-led ECMO program, ECMO coordinator, ECMO specialist, and organized training2 that includes low- to high-fidelity simulations.3 Results: The KFSH&RC ECMO nursing-led program caters for a diverse patient population and provides support in the following areas: bridge-to-transplant program such as heart and lung; adult and pediatric patients, including acute lung injury/acute respiratory distress syndrome (ARDS); and cardiac surgeries and congenital anomalies.

In addition, KFSH&RC is establishing a referral and transport system to acknowledge our center as supporter to the surrounding organizations to refer patients.

In 2014, KFSH&RC provided 30 ECMO supports, of which 26 were for cardiac support.

A total of 39 ECMO supports were provided in 2015, of which six were post-lung transplant and three related to acute lung injury.

A total of 66 patients were treated with veno-arterial ECMO with a survival to decannulation of 56.6 and 46.15% in 2014 and 2015, respectively With recent advancement, KSH&RC has initiated the extracorporeal cardiopulmonary resuscitation (ECPR) life support program and activation of code ECMO services under the facility with unified code pager and team.

Conclusion: The results highlight that a developed nursing-led ECMO program can improve patient outcomes and provide safe transport services.1 Further study is required to determine whether ECMO patient outcomes will continue to improve with less complications and good survival rate.