GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

Stuart Gillon; Chunyu Zheng; Zhiqiang Feng; Marcel Fleig; Tommaso Scquizzato; Jan Belohlávek; Roberto Lorusso; Nazir I Lone; Justyna Swol

doi:10.1177/02676591231160471

GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

Stuart Gillon, Chunyu Zheng, Zhiqiang Feng, Marcel Fleig, Tommaso Scquizzato, Jan Belohlávek, Roberto Lorusso, Nazir I Lone, Justyna Swol

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Introduction: A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS.
Methods: Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available.
Results: 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within one hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0-14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours.
Conclusions: ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

Original language	English
Journal	Perfusion
Early online date	6 Mar 2023
DOIs	https://doi.org/10.1177/02676591231160471
Publication status	E-pub ahead of print - 6 Mar 2023

Keywords / Materials (for Non-textual outputs)

ECLS
ECMO
extracorporeal life support
extracorporeal membrane oxygenation
geospatial analysis
regionalization

Access to Document

10.1177/02676591231160471

PRF-22-0402.R1_GENERATE_ clean versionAccepted author manuscript, 587 KB

Cite this

@article{62e21529ce2d44c791d57ece65f293a9,

title = "GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)",

abstract = "Introduction: A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. Methods: Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. Results: 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within one hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0-14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. Conclusions: ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality. ",

keywords = "ECLS, ECMO, extracorporeal life support, extracorporeal membrane oxygenation, geospatial analysis, regionalization",

author = "Stuart Gillon and Chunyu Zheng and Zhiqiang Feng and Marcel Fleig and Tommaso Scquizzato and Jan Belohl{\'a}vek and Roberto Lorusso and Lone, {Nazir I} and Justyna Swol",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: EuroELSO | European Extracorporeal Life Support Organization – EuroELSO Grant 2019-010. The grant has been used to fund project related costs, but not for financing single authors or any other persons related to the project. Funding Information: We kindly thank all survey participants. We thank Judith Krukenberg, Public Relations Department, Klinikum Nuremberg, Germany for general supervision of the survey management and data management. We thank Victoria Schmitt and Christian Reim from INTERPLAN (Hamburg, Germany) for their support providing survey graphics and announcement via newsletter. We also thank the members of EuroELSO Steering and Scientific Committees, Velia Marta Antonini, Martin Balik, Mirko Belliato, Jan Belohlavek, Mikael Broman, Alain Combes, Mark Davidson, Antonella Degani, Matteo DiNardo, Dirk Donker, Simon Finney, Jo-Anne Fowles, Maximilian Halbe, Felix Hennig, Aparna Hoskote, Tim Jones, Christian Karagiannidis, Roberto Lorusso, Thomas M{\"u}ller, Chirine Mossadegh, Luis Pinto, Peter P. Roeleveld, Peter Schellongowski, Matthieu Schmidt, Jonathan H. Smith, Leen Vercaemst, for support in survey design and approval. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: EuroELSO | European Extracorporeal Life Support Organization – EuroELSO Grant 2019-010. The grant has been used to fund project related costs, but not for financing single authors or any other persons related to the project. Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

month = mar,

day = "6",

doi = "10.1177/02676591231160471",

language = "English",

journal = "Perfusion",

issn = "0267-6591",

publisher = "SAGE Publications Ltd",

}

TY - JOUR

T1 - GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

AU - Gillon, Stuart

AU - Zheng, Chunyu

AU - Feng, Zhiqiang

AU - Fleig, Marcel

AU - Scquizzato, Tommaso

AU - Belohlávek, Jan

AU - Lorusso, Roberto

AU - Lone, Nazir I

AU - Swol, Justyna

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: EuroELSO | European Extracorporeal Life Support Organization – EuroELSO Grant 2019-010. The grant has been used to fund project related costs, but not for financing single authors or any other persons related to the project. Funding Information: We kindly thank all survey participants. We thank Judith Krukenberg, Public Relations Department, Klinikum Nuremberg, Germany for general supervision of the survey management and data management. We thank Victoria Schmitt and Christian Reim from INTERPLAN (Hamburg, Germany) for their support providing survey graphics and announcement via newsletter. We also thank the members of EuroELSO Steering and Scientific Committees, Velia Marta Antonini, Martin Balik, Mirko Belliato, Jan Belohlavek, Mikael Broman, Alain Combes, Mark Davidson, Antonella Degani, Matteo DiNardo, Dirk Donker, Simon Finney, Jo-Anne Fowles, Maximilian Halbe, Felix Hennig, Aparna Hoskote, Tim Jones, Christian Karagiannidis, Roberto Lorusso, Thomas Müller, Chirine Mossadegh, Luis Pinto, Peter P. Roeleveld, Peter Schellongowski, Matthieu Schmidt, Jonathan H. Smith, Leen Vercaemst, for support in survey design and approval. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: EuroELSO | European Extracorporeal Life Support Organization – EuroELSO Grant 2019-010. The grant has been used to fund project related costs, but not for financing single authors or any other persons related to the project. Publisher Copyright: © The Author(s) 2023.

PY - 2023/3/6

Y1 - 2023/3/6

N2 - Introduction: A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. Methods: Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. Results: 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within one hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0-14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. Conclusions: ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

AB - Introduction: A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. Methods: Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. Results: 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within one hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0-14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. Conclusions: ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

KW - ECLS

KW - ECMO

KW - extracorporeal life support

KW - extracorporeal membrane oxygenation

KW - geospatial analysis

KW - regionalization

U2 - 10.1177/02676591231160471

DO - 10.1177/02676591231160471

M3 - Article

SN - 0267-6591

JO - Perfusion

JF - Perfusion

ER -

GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

Access to Document

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Cite this