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Royal Brompton & Harefield NHS Foundation Trust
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Critical care and anaesthesia

ECMO and severe respiratory failure service

Royal Brompton Hospital provides ECMO (extracorporeal membrane oxygenation) for adults. The hospital is one of five centrally-funded severe acute respiratory failure centres in England able to offer ECMO.


ECMO oxygenates the blood from outside the body when the lungs are unable to do so. An ECMO machine is similar to the equipment used during a heart-lung bypass operation.

Royal Brompton's severe respiratory failure and ECMO clinicians provide support to 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 should it be required.

The service offers:

  • imaging reviews
  • thoracic surgical input
  • high-frequency oscillation
  • extracorporeal carbon dioxide removal
  • ECMO support.

We provide a 24/7 consultant-delivered retrieval service that can provide mobile ECMO when necessary.


In the highly unlikely event that we do not have sufficient capacity to accept a patient, we will find an ECMO bed from one of the other four ECMO centres in England.


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


We are keen to discuss patients in whom adequate arterial blood gases cannot be achieved using lung protective tidal volumes and pressures.


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.



How to refer your patient for ECMO


You can refer a patient for consideration of ECMO through the Hospital to Home website.


Refer a patient for ECMO


You should follow this up with a call to 020 7351 8585


Read about  referral criteria for ECMO services.


Find out more about the Hospital to Home service.



The ECMO team


The team at Trust consists of 21 consultants:


  • Dr Cliff Morgan - cross-site director of intensive care
  • Dr Andrea Kelleher - director of anaesthesia and critical care
  • Mr Richard Trimlett - ECMO lead

  • Dr Donna Hall
  • Dr Clara Hernadez
  • Dr Ana Hutardo
  • Dr Sunndeep Kaul

These ECMO specialists work closely with Anoma Gunawardena (lead nurse for ECMO) and Tim Jackson (chief perfusionist).


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 the ECMO team will accept telephone calls at any time.

 
Tel: +44 (0)20 7351 8585
Fax: +44 (0)20 7351 8524
Email: ecmo@rbht.nhs.uk



Overview of the ECMO service


Watch a video about referring into the ECMO service