EXCEL

A collaborative bi-national registry on the treatment and outcomes of patients requiring extracorporeal membrane oxygenation (ECMO) in ICU

Aim: To generate a binational multidisciplinary network of integrated care for patients requiring ECMO to monitor long term outcomes and identify best practice.

Rationale: ECMO is associated with significant costs, risks and requires specialist training and expertise. EXCEL is a novel, high-quality, detailed prospective registry of patients requiring ECMO in Australia and New Zealand. The registry provides information on patient selection, complications, costs and patient reported outcome measures. EXCEL uses the Theoretical Domains Framework to identify evidence-practice gaps and explore barriers and enablers to tailor implementation of evidence.

Study Progress: The first participant was enrolled in February 2019 and EXCEL has since enrolled 392 participants across 24 active sites. An additional 6 sites have expressed interest and are currently completing local governance applications. EXCEL has commenced six and twelve month patient follow up assessments. A streamlined process allows data to be submitted directly to ELSO and all sites receive quarterly EXCEL reports.

EXCEL has been designed to answer investigator-initiated hypothesis driven questions.

There are four studies embedded in EXCEL:

  • BLENDER
  • ECMO CARD
  • ECMO ENERGY
  • OBLEX
  • Keep up to date by following EXCEL on twitter @EXCELoutcomes

    Trial Registration: Clinicaltrials.gov NCT03793257

    Endorsement: EXCEL has been endorsed by the ANZICS-CTG and the International ECMO Network.

    International ECMO Collaborations:

    The RESP Score has been developed by researchers at ELSO, the Department of Intensive Care at The Alfred Hospital, Melbourne, and the Australian and New Zealand Intensive Care Research Centre (ANZIC-RC). It is designed to assist prediction of survival for adult patients undergoing Extracorporeal Membrane Oxygenation for respiratory failure. It should not be considered for patients who are not on ECMO or as a substitute for clinical assessment.

    The SAVE Score has been developed by researchers at ELSO, the Department of Intensive Care at The Alfred Hospital, Melbourne, and the Australian and New Zealand Intensive Care Research Centre (ANZIC-RC). It is designed to assist prediction of survival for adult patients undergoing Extracorporeal Membrane Oxygenation for refractory cardiogenic shock. It should not be considered as a substitute for clinical assessment.

    Publications:

    1. Linke NJ, Fulcher BJ, Engeler DM, et al; EXCEL Investigators. A survey of extracorporeal membrane oxygenation practice in 23 Australian adult intensive care units. Crit Care Resusc 2020;22(2):166-70. PMID: 32389109
    2. Fulcher BJ, Nicholson AJ, Linke NJ, Berkovic D, Hodgson CL; EXCEL Study Investigators and the International ECMO Network. The perceived barriers and facilitators to implementation of ECMO services in acute hospitals. Intensive Care Med. 2020;46(11):2115-7. PMID: 32705292
    3. Hodgson CL, Burrell AJC, Engeler DM, Pellegrino VA, Brodie D, Fan E, International ECMO Network. Core Outcome Measures for Research in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation for Acute Respiratory or Cardiac Failure: An International, Multidisciplinary, Modified Delphi Consensus Study. Crit Care Med 2019;47(11):1557-63. PMID: 31389837
    4. ECMO-PT Study Investigators; International ECMO Network. Early mobilisation during extracorporeal membrane oxygenation was safe and feasible: a pilot randomised controlled trial. Intensive Care Med 2020;46(5):1057-9. PMID: 32179935

    Contact: For further information about this study, please contact the EXCEL Chief Investigator Professor Carol Hodgson or EXCEL Project Manager Natalie Linke.

    Photo of Associate Professor Carol Hodgson

    COVID-19 Adult Australian ECMO Patients

    Data is updated thanks to the generous support of our EXCEL Research Coordinators and Principal Investigators at each Adult Australian ECMO Centre.

    Please visit the following websites for further information on COVID-19: