Dr. Soled’s project explores how physicians determine which patients are eligible for extracorporeal membrane oxygenation (ECMO) — a life support system used in cases of heart or lung failure or for patients awaiting transplant. While ECMO is standard in intensive care units (ICUs), its cost and risk of complications make selecting the right patient critically important. To better understand how decisions around ECMO use are made in ICUs, Dr. Soled interviewed 24 clinicians, including 10 based outside the United States. Halfway through the analysis, he has already identified significant inconsistencies. Factors such as streamlining critical care for cancer patients, location, staffing, and even time of day influence decisions more than a patient’s medical history. These variations contribute to inequities in care and unnecessary healthcare spending.

As part of the project, Dr. Soled is collaborating with intensivists at Mass General Hospital, and his early findings have been shared with division chiefs at both Mass General and the Brigham. Leaders at these institutions are optimistic that Dr. Soled’s work could help shape clinical guidelines for ECMO use across Mass General Brigham (MGB) as MGB continues to ensure delivery of its top-quality, safe care to every patient as a unified system.