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在一家三级转诊中心开展成人移动体外膜肺氧合的五年经验。

Five-year experience with mobile adult extracorporeal membrane oxygenation in a tertiary referral center.

作者信息

Vaja Ricky, Chauhan Ishaan, Joshi Vijay, Salmasi Yousuf, Porter Richard, Faulkner Gail, Harvey Chris

机构信息

Glenfield Hospital, Leicestershire, UK.

Glenfield Hospital, Leicestershire, UK.

出版信息

J Crit Care. 2015 Dec;30(6):1195-8. doi: 10.1016/j.jcrc.2015.07.032. Epub 2015 Aug 4.

Abstract

INTRODUCTION

Mobile extracorporeal membrane oxygenation (ECMO) is reserved for critically unstable patients who may not otherwise survive transfer to the ECMO center. We describe our experience with mobile ECMO.

METHODS

We retrospectively reviewed adult patients between 2010 and 2014 who were referred for ECMO support and were too unwell for conventional transfer. They were cannulated at their referring center by our team and subsequently transported back to our hospital on ECMO.

RESULTS

A total of 102 patients were put on ECMO by our team. Of 102 patients, 95 (93%) were managed by venovenous ECMO, and 7 (7%), by venoarterial ECMO. The average distance traveled was 195 miles (SD, ±256.8; range, 3.6-980). Transportation was via road in 77 cases (77%), by air in 22 cases (22%), and in 3 cases (3%) a combination of road and air was used. A double-lumen Avalon cannula was used in 72 patients (70%). One patient had a ventricular tachycardia arrest during cannulation but was successfully resuscitated. There was no mortality or major complications during transfer.

CONCLUSION

The use of mobile ECMO in adult patients is a safe modality for transfer of critically unwell patients. We have safely used double-lumen cannulas in most of these patients.

摘要

引言

移动体外膜肺氧合(ECMO)适用于病情极度不稳定、否则可能无法存活至转运至ECMO中心的患者。我们描述了我们在移动ECMO方面的经验。

方法

我们回顾性分析了2010年至2014年间因需要ECMO支持且病情过重无法进行传统转运而转诊的成年患者。我们的团队在转诊中心为他们进行插管,随后通过ECMO将他们转运回我们医院。

结果

我们的团队共为102例患者实施了ECMO。在这102例患者中,95例(93%)采用静脉-静脉ECMO治疗,7例(7%)采用静脉-动脉ECMO治疗。平均转运距离为195英里(标准差,±256.8;范围,3.6 - 980)。77例(77%)通过公路转运,22例(22%)通过航空转运,3例(3%)采用公路和航空联合转运。7

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