Scottish Government

ISBN 978 0 7559 9297 3 (Web only publication)
This document is also available in pdf format (768k)

Contents

Executive summary
The role of ECMO in critical care
Recommendations

Chapter 1: Introduction
Background - Expert Group
Working Methods
ECMO - Definition and development
Current UK provision of respiratory ECMO for children
Current UK provision of respiratory ECMO for adults
H1N1 Influenza

Chapter 2: ECMO Evidence Base
Clinical Effectiveness
Safety
Economics
Conclusion
Additional evidence: critical mass

Chapter 3: Modelling demand
Difficulties of modelling demand
Quantitative Assessment of Need for ECMO therapy in Scotland
Projected Requirements
Conclusion

Chapter 4: Principles & requirements of an ECMO service
Standards and quality assurance
Service Design
Where to embed
Co-location: vital services
Co-location: desirable services
Staff requirements
Retrieval and repatriation
Networking
Projected costs of a new service in Scotland
Likely costs of continuing access to UK service
Conclusion

Chapter 5: Summary of conclusions and recommendations
Evidence of efficacy and safety
Cost Effectiveness
Demand
Service Model
Recommendations

APPENDIX 1: MEMBERSHIP OF THE SCOTTISH ECMO EXPERT GROUP
APPENDIX 2: ACKNOWLEDGEMENTS
APPENDIX 3: STANDARD EVIDENCE TEMPLATE
APPENDIX 4: GROUP AND EXPERT VIEWS ON ESSENTIAL AND DESIRABLE SERVICES
APPENDIX 5: SAMPLE ECMO INDICATIONS/ CONTRA INDICATIONS
APPENDIX 6: ELSO GUIDELINES FOR ECMO CENTRES
APPENDIX 7: NHS QUALITY IMPROVEMENT SCOTLAND ( NHSQIS): REVIEW OF EVIDENCE BASE FOR ADULT RESPIRATORY ECMO
APPENDIX 8: PAEDIATRIC ECMO COST PROFILE 2008/9
APPENDIX 9 : COSTS OF ECMO RETRIEVAL SERVICE IN NEW SOUTH WALES
APPENDIX 10: COSTS OF ADULT ECMO SERVICE AT LEICESTER IN 2009/10
APPENDIX 11: QUANTITATIVE ASSESSMENT OF NEED FOR ECMO THERAPY IN SCOTLAND
APPENDIX 12: CRITICALLY APPRAISED TOPIC: ECMO FOR SEVERE RESPIRATORY FAILURE (DR CHRIS CAIRNS, SCOTTISH INTENSIVE CARE SOCIETY'S EVIDENCE BASED MEDICINE GROUP)