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Royal Brompton & Harefield NHS Foundation Trust
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Critical care and anaesthesia

ECMO and severe respiratory failure service

Extracorporeal Membrane Oxygenation (ECMO) and Severe Acute Respiratory Failure (SARF)


Royal Brompton Hospital (RBH) is one of the five centrally-funded ECMO centres for adult SARF in England. 


ECMO oxygenates the blood drained from the patient, which is then returned to the patient when their lungs are unable to do so. An ECMO machine is similar to equipment used during a heart-lung bypass operation.

Royal Brompton Hospital provides SARF and ECMO support to referring hospitals in the following areas/critical care networks: 

  • London north central
  • London north west
  • South west peninsula
  • Avon and Gloucester
  • Thames Valley area of south central.

We also take patients requiring ECMO from any of the UK networks, as well as Wales should it be required.

Our service


We provide a 24/7 consultant-delivered retrieval service that can provide comprehensive advice on SARF management and mobile ECMO when necessary. 


The service offers: 


  • clinical input
  • imaging reviews
  • thoracic surgical input
  • advance mechanical ventilation
  • extracorporeal carbon dioxide removal (ECCO2R)
  • ECMO

Typical patients suitable for ECMO include those with reversible disease associated with severe hypoxaemia (eg PaO2/FiO2 < 13.3kPa) or severe hypercapnic acidosis (eg pH < 7.20) despite conventional support. 


But we welcome discussions about any patient with potentially reversible severe acute respiratory failure, particularly those in whom adequate arterial blood gases cannot be achieved using lung protective tidal volumes and pressures.


We encourage early referral and provide tailored solutions according to the requirements of the patient and referring centre. 


The potential benefits of ECMO as a lung protective strategy diminish after about one week of conventional ventilation at high pressure and high-inspired oxygen.



AICU and ECMO consultants


  • Dr Henry Bettinson
  • Dr Paulo Bianchi
  • Dr James Doyle
  • Dr Clara Hernandez
  • Dr Stefan Gurney
  • Dr Andrea Kelleher - Cross-site Director of Anaesthesia and Critical Care
  • Dr Chris Langrish
  • Dr Stephane Ledot - SARF/ECMO lead
  • Dr Cliff Morgan - Director of AICU
  • Dr Maurizio Passariello
  • Dr Brij Patel
  • Professor Susanna Price
  • Dr Alex Rosenberg
  • Mr Richard Trimlett - Mechanical Circulatory Support Lead, Cardiac surgeon
  • Dr Tina Xu


Our consultants work closely with: 


  • ECMO nurses (Anoma Gunawardena - Lead nurse for ECMO)
  • Perfusion department (Tim Jackson - Chief Perfusionist)
  • Respiratory and ILD consultants
  • Cardiothoracic surgeons
  • Radiology department (Professor Sujal Desai - Consultant Radiologist)
  • Latanya Chamberlain (SARF/ECMO coordinator)


ECMO

Featured in the press


Royal Brompton's ECMO service was featured on Channel 5 news in January 2018, as they visited the hospital's intensive care to look at how 'a specialist unit is treating patients hardest hit by the winter flu outbreak'. 


Health correspondent Catherine Jones reported, to a national audience of around one million, that "When all else fails, and flu is about to claim someone's life, ECMO is the machine that can save them – technology so specialised that Royal Brompton is one of a network of just five hospitals where it's available", describing our service as for "patients so sick that conventional intensive care cannot save them."

 

Kate Harty, wife of a patient on AICU with flu and pneumonia, told 5 News: "We needed a miracle, and that's exactly what we can call the Brompton. It was my miracle."


Watch the full report


With thanks to Channel 5 news

Royal Brompton

Sydney Street,
London SW3 6NP
Tel: +44 (0)20 7352 8121

Harefield

Contact details


If you need urgent advice, or would like an update on the patient you have referred, the ECMO team will accept telephone calls at any time.

 
ECMO nurse mobile: 07815 494 175

Switchboard: 020 7351 8121

ECMO referral email: rbh-tr.ecmoreferral@nhs.net

Other ECMO enquiries: ecmo@rbht.nhs.uk



Overview of the ECMO service


Watch a video about referring into the ECMO service

 


ECMO referrals


Information on how to refer a patient for ECMO and the relevant referral forms.