Outcomes of the first 30 cases of an adult extracorporeal membrane oxygenation program: strategies to manage the "learning curve" and implications for intensive care unit risk adjustment models.

Background: We established an adult extracorporeal membrane oxygenation (ECMO) service for cardiorespiratory support in April 2009. Complex therapies may show a learning curve and volume-outcome relationship.

Objectives: To describe our model of care, casemix and outcomes for the first 30 cases together with unique features of this service and potential strategies to manage the learning curve.