Lindén V, Palmér K, Reinhard J, Westman R, Ehrén H, Granholm T, Frenckner B
Department of Pediatric Anesthesiology and Intensive Care, Astrid Lindgren Children's Hospital, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden.
Intensive Care Med. 2001 Oct;27(10):1643-8. doi: 10.1007/s001340101060.
To evaluate the experiences and results from inter-hospital transportation of patients with acute respiratory failure on extracorporeal membrane oxygenation (ECMO).
Observational, descriptive study.
Tertiary referral center in a University Hospital.
When standard ECMO criteria were fulfilled and the patient considered too unstable for a conventional transport, the mobile ECMO team cannulated the patient for ECMO at the referring hospital. The patients were then transported to our ECMO center by ground ambulance, helicopter or fixed-wing vehicle. Patients were also transported on ECMO from our ECMO center to other centers due to shortage of available ECMO beds.
29 patients (15 neonates, seven pediatric, and seven adult patients) with acute respiratory failure were transported on ECMO on a total of 30 occasions. Median time from arrival of the ECMO team at the referring hospital until the patient was on ECMO (28 patients) was 2.2 h (range 1.25-4.25 h). The median time that the transport team was out was 10 h (range 5.5-36.5 h) and the median time with the patient was 6 h (range 3-30.5 h). The distance of transport ranged from 4-1,500 km. Six transports were international. No patient complications occurred during the transports. Two technical complications related to the transport vehicle were encountered. One ambulance compressor malfunctioned. During one helicopter transport, one out of two electric supply circuits malfunctioned. The patients were not affected. Twenty-one of the 29 patients survived to discharge (72%). None of the deaths was transport related.
Tertiary intensive care units and ECMO centers require a dedicated transport team. ECMO transports can be performed safely for all age groups for long distances, probably throughout most of Europe.
评估体外膜肺氧合（ECMO）支持下急性呼吸衰竭患者院际转运的经验及结果。
观察性描述性研究。
大学医院的三级转诊中心。
当患者符合标准ECMO治疗标准且被认为病情过于不稳定而无法进行常规转运时，移动ECMO团队在转诊医院为患者实施ECMO置管。随后患者通过地面救护车、直升机或固定翼飞机转运至我们的ECMO中心。由于ECMO床位不足，部分患者也从我们的ECMO中心通过ECMO转运至其他中心。
29例急性呼吸衰竭患者（15例新生儿、7例儿科患者和7例成人患者）共接受了30次ECMO转运。ECMO团队抵达转诊医院至患者开始接受ECMO治疗（28例患者）的中位时间为2.2小时（范围1.25 - 4.25小时）。转运团队外出的中位时间为10小时（范围5.5 - 36.5小时），与患者在一起的中位时间为6小时（范围3 - 30.5小时）。转运距离为4 - 1500公里。6次转运为国际转运。转运过程中未发生患者并发症。遇到2例与转运车辆相关的技术并发症。一辆救护车压缩机发生故障。在一次直升机转运中，两个供电电路中的一个发生故障。患者未受影响。29例患者中有21例存活出院（72%）。所有死亡均与转运无关。
三级重症监护病房和ECMO中心需要一支专门的转运团队。ECMO转运对于所有年龄组均可安全地进行长距离转运，可能在欧洲大部分地区都能实现。
