Frazier W Joshua, Shepherd Edward G, Gee Samantha W
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA.
Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA;; Critical Care Transport Team, Nationwide Children's Hospital, Columbus, OH, USA.
Ann Transl Med. 2017 Feb;5(4):68. doi: 10.21037/atm.2016.10.74.
Pediatric lung transplantation is a life-saving intervention for children with irreversible end-stage lung disease. Access to transplant can be limited by geographic isolation from a center or the presence of comorbidities affecting transplant eligibility. Extracorporeal membrane oxygenation (ECMO)-supported patients are an uncommon but historically high-risk cohort of patients considered for lung transplant. We report the development of a service at our center to provide transport services to our hospital for patients unable to wean from ECMO support at their local institution for the purpose of evaluation for lung transplantation by our program. We developed a process for pre-transport consultation by the lung transplant physician team, standardized hand-off tools and equipment lists, and procedures for transitioning patients to transport ECMO machinery. Four patients have been transported to date including fixed wing (FW) and helicopter transports. All patients were successfully transported with either none or minor complications. Transport of ECMO-supported patients is a feasible method to increase access of patients with irreversible lung injured patients to evaluation for lung transplant.
小儿肺移植是对患有不可逆终末期肺病儿童的一种挽救生命的干预措施。获得移植的机会可能会受到与移植中心地理位置隔离或存在影响移植资格的合并症的限制。体外膜肺氧合(ECMO)支持的患者是考虑进行肺移植的一个不常见但历史上风险较高的患者群体。我们报告了我们中心开展的一项服务,即为那些在当地机构无法脱离ECMO支持的患者提供转运至我院的服务,以便我们的项目对其进行肺移植评估。我们制定了肺移植医生团队进行转运前会诊的流程、标准化的交接工具和设备清单,以及将患者过渡到转运ECMO设备的程序。迄今为止,已有4名患者被转运,包括固定翼飞机(FW)和直升机转运。所有患者均成功转运,无一例或仅有轻微并发症。转运ECMO支持的患者是一种可行的方法,可增加不可逆肺损伤患者接受肺移植评估的机会。