Ando Makoto, Takahashi Yukihiro, Park In-Sam, Tomoike Hitonobu
Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute.
Circ J. 2015;79(1):180-4. doi: 10.1253/circj.CJ-14-0597. Epub 2014 Nov 17.
There is currently a well-established network for the allocation of donor organs for transplantation in Japan, and emergency patients are often transported by the "Doctor Helicopter". However, interhospital transfer of patients, which can require aircraft with specialized equipment, depends on arrangement by each responsible hospital.
Since 2009 there were 41 interhospital aviation transfers of pediatric patients with intractable cardiac or airway diseases seeking surgical treatment at Sakakibara Heart Institute. Of these, 22 were newborns, 21 were on continuous drip infusion and 14 on mechanical ventilator support. In 15 cases (36.6%), a commercial airliner was used, with the remaining using chartered emergency aircraft (eg, local fire department helicopter, Self-Defense-Forces of Japan and the Doctor Helicopter). The median transfer time was 239 min for commercial airliners, 51 min for chartered aircraft departing directly from the referring hospital and 120.5 min for chartered aircraft departing from a nearby location. The efficiency of the transfer exemplified by the percentage of the time on board the aircraft was significantly lower for commercial airliners compared with chartered emergency aircraft.
Further efforts and cooperation with government are required to obtain geographically uniform availability of carriers with optimal medical equipment to improve pediatric patient outcomes.
目前日本已建立了完善的供移植用捐赠器官分配网络,急诊患者常通过“医生直升机”转运。然而,患者的院际转运可能需要配备专业设备的飞机,这取决于各责任医院的安排。
自2009年以来,有41例患有顽固性心脏或气道疾病的儿科患者从各医院通过航空转运至酒匂原心脏研究所寻求手术治疗。其中,22例为新生儿,21例持续静脉滴注,14例接受机械通气支持。15例(36.6%)使用了商业客机,其余使用包机(如当地消防部门直升机、日本自卫队直升机和医生直升机)。商业客机的转运中位时间为239分钟,从转诊医院直接起飞的包机为51分钟,从附近地点起飞的包机为120.5分钟。以飞行时间占比衡量的转运效率,商业客机显著低于包机。
需要进一步努力并与政府合作,以使各地都能获得配备最佳医疗设备的运输工具,从而改善儿科患者的治疗效果。