Arlt Matthias, Philipp Alois, Zimmermann Markus, Voelkel Sabine, Hilker Michael, Hobbhahn Jonny, Schmid Christof
Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany.
Resuscitation. 2008 Jun;77(3):345-50. doi: 10.1016/j.resuscitation.2008.01.003. Epub 2008 Mar 4.
As a result of healthcare changes, interhospital transfer has become common in the care even of patients with severely deteriorated cardiopulmonary function. This study describes experience with the use of a specially downsized, lightweight extracorporeal circulation system (Emergency-MECC) which enables percutaneous cardiopulmonary bypass support in resistant cases of severe cardiac and cardiopulmonary failure.
Between March 2006 and June 2007, the Emergency-MECC system, consisting of a centrifugal pump and a membrane oxygenator, was used to facilitate interhospital transfer of five adults. The technique included percutaneous cannulation, femoro-femoral venoarterial (n=4) and femoro-jugular venovenous (n=1) life support by extracorporeal membrane oxygenation.
Bedside cannulation was uneventful and the extracorporeal circulation support achieved adequate systemic blood flow and oxygen delivery in all cases. Vasopressor support could be immediately reduced and hypoxaemia was treated effectively. During interhospital transfer (air ambulance in three and ground ambulance in two cases), no technical complication occurred. Hospital survival rate was 80%.
The Emergency-MECC system is safe, rapid and highly effective in restoring blood flow and oxygen delivery. Interhospital transfer on cardiopulmonary bypass was made possible without extended technical or personnel support.
由于医疗保健的变革，即使是心肺功能严重恶化的患者，院际转运在其治疗过程中也已变得很常见。本研究描述了使用一种特别小型化、轻量化的体外循环系统（Emergency-MECC）的经验，该系统能够在严重心脏和心肺衰竭的难治性病例中提供经皮心肺旁路支持。
在2006年3月至2007年6月期间，由离心泵和膜式氧合器组成的Emergency-MECC系统被用于协助5名成人的院际转运。该技术包括经皮插管，通过体外膜肺氧合进行股-股静脉动脉（n = 4）和股-颈静脉静脉（n = 1）生命支持。
床边插管顺利，体外循环支持在所有病例中均实现了足够的全身血流和氧输送。血管升压药支持可立即减少，低氧血症得到有效治疗。在院际转运期间（3例使用空中救护车，2例使用地面救护车），未发生技术并发症。医院生存率为80%。
Emergency-MECC系统在恢复血流和氧输送方面安全、快速且高效。无需额外的技术或人员支持即可实现心肺旁路下的院际转运。
