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使用静脉-静脉体外膜肺氧合(ECMO)对重症急性呼吸窘迫综合征(ARDS)患者进行院际转运:ECMO转运团队的概念

Interhospital transfer of seriously sick ARDS patients using veno-venous Extracorporeal Membrane Oxygenation (ECMO): Concept of an ECMO transport team.

作者信息

Starck Christoph T, Hasenclever Peter, Falk Volkmar, Wilhelm Markus J

机构信息

Department of Cardiac Surgery, Clinic of Cardiac and Vascular Surgery, University Hospital, Zurich, Switzerland.

出版信息

Int J Crit Illn Inj Sci. 2013 Jan;3(1):46-50. doi: 10.4103/2229-5151.109420.

Abstract

BACKGROUND

Extracorporeal membrane oxygenation (ECMO) therapy constitutes the last option for patients with acute respiratory distress syndrome (ARDS) refractory to conservative treatment. Since primary care centers are unable to provide this therapy, such patients need a transfer to a tertiary care center, which may be life-threatening without extracorporeal support.

METHODS

An ECMO transport team implanted an ECMO at the site of the primary care center with subsequent transport of the patient to the tertiary care center. Between September 2009 and March 2011, six patients with ARDS were treated by our ECMO transport team. Mean age was 39.5±12.0 years. All implantations were done percutaneously in a veno-venous configuration.

RESULTS

No complications occurred during the implant procedure and the subsequent transport. Four patients (67%) were successfully weaned from ECMO-therapy, and discharged from hospital.

CONCLUSION

With a specialized ECMO transport team, ECMO-implantation can be achieved successfully in a peripheral hospital, and patients can be transported safely.

摘要

背景

体外膜肺氧合(ECMO)治疗是急性呼吸窘迫综合征(ARDS)保守治疗无效患者的最后选择。由于基层医疗中心无法提供这种治疗,此类患者需要转至三级医疗中心,若无体外支持,这可能会危及生命。

方法

一个ECMO转运团队在基层医疗中心为患者植入ECMO,随后将患者转运至三级医疗中心。2009年9月至2011年3月期间,我们的ECMO转运团队治疗了6例ARDS患者。平均年龄为39.5±12.0岁。所有植入均采用经皮静脉-静脉配置方式进行。

结果

植入过程及后续转运期间均未发生并发症。4例患者(67%)成功脱离ECMO治疗并出院。

结论

借助专业的ECMO转运团队,可在外周医院成功植入ECMO,并安全转运患者。

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