**3. Extracorporeal Membrane Oxygenation (ECMO)**

Monitoring of the outcomes from extracorporeal membrane oxygenation (ECMO) is via the annual reporting of each centres activity and outcomes as submitted to the international voluntary Extracorporeal Life Support Organisation (ELSO). Membership of ELSO is a requirement of each centre as part of the national service and ensures that the data collected on outcomes are consistent internationally, thus allowing benchmarking of outcomes across organisations.

#### **3.1 Extracorporeal membrane oxygenation (ECMO) for adults and children with potentially reversible severe respiratory failure**

Extracorporeal Membrane Oxygenation (ECMO) for adults and children with potentially reversible severe respiratory failure has been nationally commissioned in England since 1997. Currently ECMO is provided by the current hospital Trusts:


There is also a children's ECMO service in provided at Yorkhill Hospital, Glasgow, that is commissioned by National Services Division Scotland. The four providers of ECMO for children with potentially reversible severe respiratory failure work in collaboratively to ensure the needs of the UK are met.

All providers of the national ECMO programme (adult and / or paediatric) are registered with the Extracorporeal Life Support Organisation (ELSO) which is the international registry recording the outcomes for patients receiving ECMO. All centres provide their anonymised activity and outcome data on an annual basis to the National Specialised Commissioning Team as part of the end of year review visits to each centre.

This data collection and presentation is supplemented by an annual meeting of all the UK centres along with representatives from the ECMO service at the Karolinska Institute, Stockholm, where each centre's anonymised activity and outcomes are presented along with agreed educational topics relating to recent experience or anticipated innovation. Again, this facilitates joint learning and service improvement in a very open and transparent setting.

National commissioning of the adult ECMO service enabled the definitive trial of ECMO in adults with potentially reversible severe respiratory failure to be commissioned jointly with the National Coordinating Centre for Health Technology Assessment (now part of the National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre). The results of this trial were published in the Lancet in September 2009 (Peek et al., 2009) and as a NIHR Health Technology Assessment Monograph in 2010 (Peek et al., 2010).
