Mobile ICU-supported ECMO rapid response team: A paradigm for regional critical care optimization

Extracorporeal membrane oxygenation (ECMO) is a cornerstone therapy for refractory cardiopulmonary failure, but its effectiveness depends on rapid coordination, initiation, and safe inter-hospital transfer. We evaluated a mobile ICU-supported ECMO rapid response team designed to reorganize ECMO delivery into a standardized, parallelized regional workflow. In a single-center retrospective cohort of 151 adults treated between 2021 and 2025, this model significantly shortened team response, circuit priming, ECMO initiation, and transfer times compared with conventional ad hoc care, while reducing mechanical complications and improving weaning rates, although without statistically significant survival benefit. Efficiency gains were consistent across age, sex, and diagnostic subgroups, underscoring the conceptual value of system-level redesign rather than new technology. These findings demonstrate the feasibility of a mobile ICU-based, hub-and-spoke ECMO network to enhance regional critical care efficiency and coordination, and provide a scalable framework for future prospective and multicenter evaluation.