Extra-Corporeal Life Support

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Background

The extra-corporeal life support (ECLS) service is based at the Royal Hospital for Children at the South Glasgow Hospitals campus in Shieldhall, Govan. The service provides temporary life support to children and babies with cardiac or pulmonary failure in both the Paediatric and the Neonatal Intensive Care Units. It is one of four such services in the UK, and is the only one in Scotland. The service plays a key role in supporting the Scottish national paediatric cardiac surgery programme.  The other UK hospitals are in Leicester, Newcastle and Great Ormond Street Hospital, London. The children's hospitals in Birmingham and Liverpool provide "surge" respiratory ECLS capacity during periods of exceptional demand.

The ECLS service was established at the Royal Hospital for Sick Children, Yorkhill in 1992 and was designated as a Scottish national service, funded by the National Services Division (NSD) of NHS Scotland from April 2001. It is a highly specialised service; reflecting the small number of patients who require this treatment and the costs associated with this service.

Activity

Since our establishment in 1992, we have supported 515 patients on ECLS with an overall survival of 80% for patients who otherwise almost certainly would have died. For the period 2005-2015, our mean activity was 40.6 ECLS runs per annum, making us one of the largest and busiest ECLS programmes in Europe. Approximately 40% of runs are for cardiac support, 34% neonatal respiratory and 26% paediatric respiratory.

Our programme is fully audited at both national and international level by the Extra-Corporeal Life Support Organisation. We are a well-regarded centre for ECLS innovation, research and training. We are in the process of assisting several newer ECLS centres with training and set-up of their programmes.

Our training makes extensive use of clinical simulation systems and we have a rolling programme of re-accreditation for all staff groups involved in the delivery of ECLS.

Developments

In 2009 the introduction of a successful centrifugal pump system for ECLS (CentriMag) allowed the introduction of smaller, more compact, easily deployable circuits for ECMO and VAD use.

The ECLS service is delighted to have applied for and received recognition by the Extra-Corporeal Life Support Organisation (ELSO) as a ‘Centre of Excellence’ for extracorporeal life support. This is a peer reviewed award which reflects our programme's strength, quality and team commitment.

Following our successful morbidity follow up programme for neonatal ECLS survivors, we are developing a similar study for older children.