VECMOS: Victoria’s statewide ECMO service explained
The Victorian ECMO Service (VECMOS) is a networked, state-coordinated approach to delivering extracorporeal life support across Victoria. Established to address inequitable access to ECMO — which had previously depended on geography and which hospital a patient happened to present to — VECMOS ensures that any Victorian patient with a life-threatening condition amenable to ECMO can access appropriate care, regardless of where they are.
Why a statewide ECMO network?
Before VECMOS, ECMO availability in Victoria varied between hospitals and was not coordinated at a system level. Patients presenting to regional hospitals with severe ARDS or refractory cardiac arrest had inconsistent access to ECMO retrieval. A 2019 review recommended formalising a state network, modelled on international examples such as the UK's ECMO centre network and the NSW ECLS programme.
VECMOS structure
VECMOS operates a tiered hub-and-spoke model:
- Tier 1 (Hub) — The Alfred Hospital, Melbourne: the primary ECMO centre with the highest volume, broadest capability (adult VV, VA, ECPR, bridge to transplant), 24/7 ECMO and retrieval availability
- Tier 2 — Regional hospitals: hospitals with ECMO capability for VV and/or VA ECMO but not the full range of services; provide ECMO locally for suitable patients and transfer complex cases to Tier 1
- Tier 3 — Referring hospitals: hospitals without ECMO capability that activate the retrieval pathway when a patient meets ECMO criteria
The retrieval pathway
When a patient in a Tier 3 hospital meets ECMO criteria, the treating intensivist contacts the Alfred ECMO programme. A coordinated retrieval — ECMO physician, perfusionist or ECMO nurse, and transport coordination — is dispatched. The Alfred ECMO retrieval team can cannulate the patient at the referring hospital and transport them on ECMO by road or air to the Alfred for definitive care.
VECMOS outcomes
Published data from the Alfred and VECMOS network demonstrate that retrieval ECMO outcomes are comparable to those for patients cannulated at the Alfred, validating the network model. Regional access to a centralised ECMO service has improved equitable outcomes across Victoria.
The Royal Children's Hospital in VECMOS
Paediatric ECMO in Victoria is centred at the Royal Children's Hospital Melbourne, which operates separately from the adult VECMOS network but with coordination pathways for paediatric cases presenting at adult hospitals.
To learn more about the Lifemotion ECMO system — ARTG-listed and exclusively distributed across Australia and New Zealand by OHM Healthcare — visit us.
For healthcare professionals and health system planners. Educational only — contact VECMOS/Alfred Hospital directly for referral pathway details.
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