Huang Shu-Chien, Chen Yih-Sharng, Chi Nai-Hsin, Hsu Jiun, Wang Chih-Hsien, Yu Hsi-Yu, Chou Nai-Kuan, Ko Wen-Je, Wang Shoei-Shen, Lin Fang-Yue
Department of Surgery and Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Artif Organs. 2006 Jan;30(1):24-8. doi: 10.1111/j.1525-1594.2006.00176.x.
Patients with cardiogenic shock refractory to conventional management require advanced mechanical circulatory support such as extracorporeal membrane oxygenation (ECMO). In hospitals lacking ECMO facilities, interhospital transportation is necessary for further patient management. Thirty-one adult cardiac patients, who were transported to our hospital by our ECMO transport team between January 1998 and July 2004, were enrolled in this study. The median transportation distance was 200 km (range: 3-300 km). During transportation, the ECMO circuit per se and the patients did not have complications. Of the 31 patients, 20 (64.2%) were weaned off ECMO or bridged to ventricular assist devices and 10 patients (32.1%) survived to discharge. Delayed transfer (>2 days) and high organ dysfunction score were associated with poor outcomes. The survival rate was similar to that of our in-hospital group (survival rate: 32.8%, n = 64). In conclusion, adult cardiogenic shock patients requiring interhospital ECMO transport had a reasonable chance of survival.
对传统治疗无效的心源性休克患者需要先进的机械循环支持，如体外膜肺氧合（ECMO）。在缺乏ECMO设备的医院，为了进一步治疗患者，需要进行院际转运。1998年1月至2004年7月期间，由我院ECMO转运团队转运至我院的31例成年心脏病患者纳入本研究。转运距离中位数为200公里（范围：3 - 300公里）。转运期间，ECMO回路本身及患者均未出现并发症。31例患者中，20例（64.2%）成功撤机或过渡到心室辅助装置，10例患者（32.1%）存活出院。延迟转运（>2天）和高器官功能障碍评分与不良预后相关。生存率与我院住院组相似（生存率：32.8%，n = 64）。总之，需要院际ECMO转运的成年心源性休克患者有合理的存活机会。
