A regional partnership model for VA-ECMO initiation and transfer from remote centers using air medical transport.

However, its use is limited to tertiary centers due to resource allocation, education, and personnel requirements.

The cannulate-and-ship model has therefore emerged to extend access to veno-arterial extracorporeal membrane oxygenation.

This model faces several communication, education, and logistical challenges.

Median transport distance was 440 km.