Cornish J D, Carter J M, Gerstmann D R, Null D M
Emory University, Atlanta, Georgia.
ASAIO Trans. 1991 Oct-Dec;37(4):564-8.
Term or near term newborns whose severity of cardiac or respiratory failure makes them candidates for extracorporeal membrane oxygenation (ECMO) are often too unstable to be safely transported to an ECMO-competent center. Faced with a large military and civilian referral population that is distributed across the entire continental United States, the authors have addressed this dilemma by developing a transportable ECMO system that can be taken to the referring hospital in a small transport aircraft. This system was on hand, but was not required, to stabilize and transport the infant in question in four cases. All had uneventful transports. Thirteen infants were placed on ECMO at their referring hospitals, one of whom died shortly after the institution of bypass. The remaining 12 infants were stabilized and transported successfully on ECMO over distances ranging from 17 to 1,437 miles, with 11 of these being long distance air transports. Four patients are long-term survivors. The authors conclude that a properly configured and managed ECMO system can effectively stabilize and transport even extremely ill neonates if the pertinent physiologic and aeromedical considerations are addressed.
患有心脏或呼吸衰竭且病情严重、适合接受体外膜肺氧合（ECMO）治疗的足月儿或近足月儿，往往病情过于不稳定，无法安全转运至具备ECMO治疗能力的中心。面对分布在美国整个大陆的大量军事和民用转诊人群，作者通过开发一种可运输的ECMO系统解决了这一难题，该系统可通过小型运输机运至转诊医院。在4例病例中，该系统随时可用，但并未用于稳定和转运相关婴儿，所有转运过程均顺利。13名婴儿在转诊医院接受了ECMO治疗，其中1例在体外循环建立后不久死亡。其余12名婴儿在接受ECMO治疗期间病情稳定并成功转运，转运距离从17英里至1437英里不等，其中11例为长途空中转运。4名患者为长期存活者。作者得出结论，如果解决了相关的生理和航空医疗问题，一个配置合理且管理得当的ECMO系统能够有效地稳定并转运病情极其严重的新生儿。
