Lunz Dirk, Philipp Alois, Judemann Katrin, Amann Matthias, Foltan Maik, Schmid Christof, Graf Bernhard, Zausig York A
Department of Anesthesiology, University Medical Center, Regensburg, Germany.
Interact Cardiovasc Thorac Surg. 2013 Nov;17(5):773-7. doi: 10.1093/icvts/ivt320. Epub 2013 Jul 19.
Based on continuous technical innovations and recent research, extracorporeal membrane oxygenation (ECMO) has become a promising tool in the treatment of patients with acute (cardio)pulmonary failure. Nevertheless, any extracorporeal technique requires a high degree of experience and knowledge, so that a restriction to specialized centres seems to be reasonable. As a consequence of this demand, the need for inter-hospital transfer of patients with severely impaired (cardio)pulmonary function is rising. Unfortunately, most of the ECMO devices used in the clinical setting are not suitable for inter-hospital transport because of their size, weight or complexity. In this article, we describe our first experiences with the airborne transport of 6 patients on a new portable, miniaturized and lightweight extracorporeal circulation system, the Medos deltastream® DP3.
Six patients suffering acute respiratory failure were taken on venovenous ECMO (DP3) out-of-centre and transferred to the University Medical Center Regensburg by helicopter. All cardiorespiratory-relevant parameters of the patients and the technical functioning of the device were continuously monitored and documented.
Implantation of the device and air-supported transport were performed without any technical complications. The patients were transported from a distance of 66-178 km, requiring a time of 40-120 min. With the help of the new deltastream® DP3 ECMO device, a prompt stabilization of the cardiopulmonary function could be achieved in all patients. One patient was under ongoing cardiopulmonary resuscitation by the time our ECMO team arrived at the peripheral hospital and died shortly after arrival in the central emergency ward.
Our experience shows that the deltastream® DP3 is an absolutely reliable and safe ECMO device that could gain growing importance in the field of airborne transportation of patients on ECMO due to its unsophisticated, miniaturized and lightweight characteristics.
基于持续的技术创新和近期研究，体外膜肺氧合（ECMO）已成为治疗急性（心）肺衰竭患者的一种有前景的工具。然而，任何体外技术都需要高度的经验和知识，因此限制在专业中心使用似乎是合理的。由于这种需求，心肺功能严重受损患者的院际转运需求不断增加。不幸的是，临床使用的大多数ECMO设备因其尺寸、重量或复杂性而不适合院际运输。在本文中，我们描述了使用新型便携式、小型化和轻量化体外循环系统Medos deltastream® DP3对6例患者进行空中转运的首次经验。
6例急性呼吸衰竭患者在院外接受静脉-静脉ECMO（DP3）治疗，并通过直升机转运至雷根斯堡大学医学中心。对患者所有与心肺相关的参数以及设备的技术运行情况进行持续监测和记录。
设备植入和空中转运均未出现任何技术并发症。患者转运距离为66 - 178公里，耗时40 - 120分钟。借助新型deltastream® DP3 ECMO设备，所有患者的心肺功能均能迅速稳定。我们的ECMO团队抵达周边医院时，有1例患者正在进行心肺复苏，抵达中央急诊病房后不久死亡。
我们的经验表明，deltastream® DP3是一种绝对可靠且安全的ECMO设备，因其简单、小型化和轻量化的特点，在ECMO患者空中转运领域可能会变得越来越重要。
