Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program)

This is an excellent article on the feasibility of offering Veno Arterial ECMO in outlying community hospitals for Refractory Cardiogenic Shock (RCS).  The Authors review a four year time period and describe assessing 104 patients of whom 87 were deemed eligible for V-A ECMO therapy. The authors conclude that providing V-A ECMO therapy in a community hospital environment for RCS is both feasible and resulted in an impressive mortality reduction of 30%.  The Authors present points regarding the need for a constantly available dedicated staff, strong logistical support, and dedicated ICU beds. In addition, the authors discuss the probability of increased costs and resource utilization.