Biscotti Mauer, Agerstrand Cara, Abrams Darryl, Ginsburg Mark, Sonett Joshua, Mongero Linda, Takayama Hiroo, Brodie Daniel, Bacchetta Matthew
Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Columbia University Medical Center, New York, New York.
Ann Thorac Surg. 2015 Jul;100(1):34-9; discussion 39-40. doi: 10.1016/j.athoracsur.2015.02.037. Epub 2015 Apr 23.
Extracorporeal life support technology has gained acceptance as a salvage mode for patients in respiratory or cardiac failure. Patients who are sick enough to require extracorporeal membrane oxygenation (ECMO) support are often too unstable for transfer to a hospital with ECMO capabilities. We highlight the progressive development of an ECMO transport team and the manner in which it provides reliable transport with excellent outcomes.
All data were collected retrospectively from our hospital's electronic medical record. Patient outcomes are reported through April 2, 2014.
Our institution began an ECMO transport program in 2008, with the initial phase involving transport of highly selected patients for short distances. With experience we refined our intake and evaluation process. We also consolidated care for ECMO patients into two intensive care units and developed a dedicated ECMO intensivist position. As the program has matured, patient selection has become more inclusive and we have extended our capabilities to include interstate and international transport. All 100 patients were successfully placed on ECMO and transported to our center. Seventy-nine patients were placed on venovenous ECMO, 19 on venoarterial ECMO, and 2 on venovenous arterial ECMO. The median transport distance was 16 miles and ranged from 2.5 to 7,084 miles.
Extracorporeal membrane oxygenation transport can be performed safely and reliably with excellent outcomes with a dedicated team that maintains stringent adherence to well-designed management protocols.
体外生命支持技术已被认可为呼吸或心力衰竭患者的一种挽救方式。病情严重到需要体外膜肺氧合（ECMO）支持的患者往往过于不稳定，无法转至具备ECMO能力的医院。我们着重介绍了ECMO转运团队的逐步发展以及其提供可靠转运并取得出色结果的方式。
所有数据均从我院电子病历中回顾性收集。患者结局报告截至2014年4月2日。
我院于2008年启动了ECMO转运项目，初始阶段涉及对经过严格挑选的患者进行短距离转运。随着经验的积累，我们完善了接收和评估流程。我们还将ECMO患者的护理整合到两个重症监护病房，并设立了专门的ECMO专科医生职位。随着项目的成熟，患者选择范围变得更加广泛，我们的能力也扩展到包括州际和国际转运。所有100例患者均成功接受ECMO并转运至我院。79例患者接受静脉 - 静脉ECMO，19例接受静脉 - 动脉ECMO，2例接受静脉 - 静脉 - 动脉ECMO。转运距离中位数为16英里，范围为2.5至7,084英里。
通过一个严格遵守精心设计的管理方案的专业团队，体外膜肺氧合转运可以安全可靠地进行，并取得出色的结果。
