Fouilloux Virginie, Gran Célia, Ghez Olivier, Chenu Caroline, El Louali Fedoua, Kreitmann Bernard, Le Bel Stéphane
1 Department of Cardiac Surgery, Timone Children Hospital, Marseille, France.
2 Faculty of Medicine, Aix-Marseille University, Marseille, France.
Perfusion. 2019 Jul;34(5):384-391. doi: 10.1177/0267659118824006. Epub 2019 Jan 12.
Extracorporeal membrane oxygenation has become a gold standard in treatment of severe refractory circulatory and/or pulmonary failure. Those procedures require gathering of competences and material. Therefore, they are conducted in a limited number of reference centers. Emergent need for such treatments induces either hazardous transfers or a mobile pediatric extracorporeal membrane oxygenation team able to remote implantation and transportation. The aim of this work is not to focus on pediatric extracorporeal membrane oxygenation outcomes or indications, which have been extensively discussed in the literature. This study would like to detail the implementation, safety, and feasibility, even in a middle-size pediatric cardiac surgery reference center.
This is a retrospective analysis of a series of patients initiated on extracorporeal membrane oxygenation in a peripheral center and transferred to a reference center. The data were collected from 10 consecutive years: from 2006 to 2016.
A total of 57 pediatric patients with a median weight of 6.00 (3.2-14.5) kg and median age of 2.89 (0.11-37.63) months were cannulated in peripheral center and transported on extracorporeal membrane oxygenation. We did not experience any adverse event during transport. The outcomes were comparable to our literature-reported on-site extracorporeal membrane oxygenation series with 42 patients (74%) weaned from extracorporeal membrane oxygenation and a 30-day survival of 60%. Neither patient's age nor weight, indication for extracorporeal membrane oxygenation or length of transport, was statistically significant in terms of outcomes.
Offsite extracorporeal membrane oxygenation implantation and ground or air transport for pediatric patients on extracorporeal membrane oxygenation appeared to be safe when performed by a dedicated and experienced team, even within a mid-size center.
体外膜肺氧合已成为治疗严重难治性循环和/或肺衰竭的金标准。这些操作需要具备专业能力和物资。因此，它们仅在少数参考中心进行。对这类治疗的紧急需求导致了危险的转运，或者催生了一个能够进行远程植入和转运的移动儿科体外膜肺氧合团队。本研究的目的不是关注儿科体外膜肺氧合的结果或适应症，这些在文献中已有广泛讨论。本研究旨在详细阐述其实施、安全性和可行性，即使是在一个中等规模的儿科心脏外科参考中心。
这是一项对在外围中心开始接受体外膜肺氧合并转至参考中心的一系列患者的回顾性分析。数据收集自连续10年：2006年至2016年。
共有57名儿科患者在外围中心进行了体外膜肺氧合插管，体重中位数为6.00（3.2 - 14.5）千克，年龄中位数为2.89（0.11 - 37.63）个月，并通过体外膜肺氧合进行转运。我们在转运过程中未经历任何不良事件。结果与我们文献报道的现场体外膜肺氧合系列相当，42例患者（74%）成功脱离体外膜肺氧合，30天生存率为60%。就结果而言，患者的年龄、体重、体外膜肺氧合的适应症或转运时间均无统计学意义。
由专业且经验丰富的团队进行时，即使在中等规模的中心内，为儿科患者进行异地体外膜肺氧合植入以及通过地面或空中转运似乎都是安全的。
