Caroline Ozment, MD, medical director of Neonatal and Pediatric ECMO at Duke Health says that successful extracorporeal cardiopulmonary resuscitation is only possible at highly trained and coordinated centers with robust extracorporeal membrane oxygenation (ECMO) systems. 

Duke Health has become a highly trained and coordinated center. According to Ozment and ECMO team general surgeon Erica Hodgman, MD, the organization consistently remains dedicated to maintaining a broad, unified extracorporeal life support approach for both adult and pediatric patients. 

“Duke’s hospital-wide commitment to providing ECMO and doing it well has empowered the providers on this team to excel in caring for these fragile patients in emergent situations,” says Hodgman.

While pediatric and adult ECMO programs at Duke have their own respective medical and surgical directors, clinicians and resources are housed together across programs, fostering collaboration, support, and responsiveness. 

Additionally, every ECMO specialist is nationally certified by the Extracorporeal Life Support Organization (ELSO) for both adult and neonatal-pediatric ECMO, a certification process that requires many hours of focused work, including extensive didactics, high-fidelity simulation, prescribed patient care hours, and passing population-specific certification exams. 
In pediatrics alone, the team performs an average of 35 to 40 ECMO cases each year, considered a significant volume given the general low frequency but high acuity nature of the specialty. 

The generally limited volume of pediatric patients needing ECMO can often make high quality research at a single institution very challenging, notes Hodgman. But Duke’s ECMO specialists have cared for enough patients and have the experience to be fully engaged in research and education that continually improves and advances care in this critical specialty within Duke and beyond. 

For example, Ozment is the national principal investigator for a clinical trial seeking FDA approval for an ECMO circuit for pediatric use. The team also participates in the development of pediatric treatment protocols, and the laboratory of Tobias Straub, MD, at Duke is developing a novel cannula design currently in pre-clinical testing that could change the course of pediatric and adult ECMO delivery across the country.

The collaborative atmosphere and collective experience of Duke’s providers allow the ECMO team to mobilize and rapidly cannulate for ECMO 24 hours a day, seven days a week. Unlike typical ECMO programs, where cannulation is limited to the intensive care unit or operating room, Duke’s pediatric ECMO team can perform cannulation wherever it is needed—including all inpatient locations and the emergency department. 

The most important thing to the team is standing primed and ready to serve as the bridge for every patient in need to quickly and safely receive this “ultimate life support.” 

“It takes so many people working together to do this quickly and safely, and we are able to do it better than most because we work so well and so closely together,” says Hodgman. “We’re here, and we’re ready when needed. This whole team does whatever it takes to take care of our patients, and to take care of each other.”