Grenda David S, Moll Vanessa, Kalin Craig M, Blum James M
Department of Anesthesiology, Division of Critical Care Medicine, Emory University Hospital, Atlanta, Georgia, USA.
Department of Perfusion, Emory University Hospital, Atlanta, Georgia, USA.
Ann Transl Med. 2017 Feb;5(4):71. doi: 10.21037/atm.2016.11.35.
Extracorporeal membrane oxygenation (ECMO) has become an increasingly utilized modality for the support of patients with severe cardiac or pulmonary dysfunction. Unfortunately, the costs and expertise required to maintain a formal ECMO program preclude the vast majority of hospitals from employing such technology routinely. These barriers to implementation of an effective ECMO program highlight the importance of the safe transport of patients in need of extracorporeal support. While many centers with extensive expertise in the management of patients on extracorporeal support have demonstrated their ability to transport those same patients, the ability of new ECMO programs to provide such transportation remains poorly studied. We established an ECMO program at our institution and immediately provided equipment and personnel to transport patients in need of or receiving extracorporeal support to our institution. Overall, we found that 13 out of 28 patients transported to our institution on ECMO or for consideration of ECMO support during the first 15 months of the program survived to hospital discharge. During that period, four incidents associated with patient transport occurred but none were related to ECMO support or adversely affected patient outcome. These observations demonstrate that new ECMO programs can safely and reliably transport patients on or in need of extracorporeal support.
体外膜肺氧合(ECMO)已越来越多地用于支持严重心肺功能障碍患者。不幸的是,维持一个正规的ECMO项目所需的成本和专业知识使得绝大多数医院无法常规采用这种技术。实施有效ECMO项目的这些障碍凸显了对需要体外支持的患者进行安全转运的重要性。虽然许多在体外支持患者管理方面有丰富经验的中心已证明他们有能力转运这些患者,但新的ECMO项目提供此类转运的能力仍研究不足。我们在本机构设立了一个ECMO项目,并立即提供设备和人员,将需要或正在接受体外支持的患者转运至本机构。总体而言,我们发现,在该项目开展的前15个月里,28例通过ECMO转运至本机构或因考虑ECMO支持而转运至本机构的患者中有13例存活至出院。在此期间,发生了4起与患者转运相关的事件,但均与ECMO支持无关,也未对患者结局产生不利影响。这些观察结果表明,新的ECMO项目能够安全、可靠地转运正在接受或需要体外支持的患者。