East Midlands Congenital Heart Centre, University Hospitals of Leicester, Leicester, England, UK.
Cardiovascular Research Centre, University of Leicester, Leicester, United Kingdom.
ASAIO J. 2021 May 1;67(5):594-600. doi: 10.1097/MAT.0000000000001286.
To review our experience with mobile extracorporeal membrane oxygenation (ECMO). Mobile ECMO team included: ECMO-trained surgeon and intensivist, specialist nurse, and perfusionist. Patients were cannulated for venous-arterial (V-A) or venous-venous (V-V) ECMO, depending on clinical indication. Mobile transfers were carried out utilizing a Levitronics Centrimag centrifugal pump and Hico Variotherm 555 heater cooler. From October 2009 to May 2019, 571 patients, 185 (32%) neonates, 95 (17%) pediatric, and 291 (51%) adults, underwent mobile ECMO transfer. Four hundred fifty-three (79%) transfers were completed by road, 76 (13%) by air, and 42 (8%) by road/air combination. Road was the travel mode of choice for journeys with expected duration up to 3 hours one way. Nevertheless, road transfers up to 6 hours duration were performed safely. Average duration of mobile ECMO transfer was 5.5 hours (2-18 hours). Two patients died before arrival of mobile ECMO team, four patients were cannulated during cardio-pulmonary resuscitation, and one of them died of uncontrollable hemorrhage in the right hemithorax. One patient had cardiac arrest after V-V cannulation and required conversion to V-A. Mobile ECMO is safe and reliable to transfer the sickest of patients. Fully trained team with all equipment and disposables is indispensable for reliable mobile ECMO service.
回顾我们使用移动体外膜肺氧合(ECMO)的经验。移动 ECMO 团队包括:接受过 ECMO 培训的外科医生和重症监护医生、专科护士和灌注师。根据临床指征,患者接受静脉-动脉(V-A)或静脉-静脉(V-V)ECMO 置管。移动转运用 Levitronics Centrimag 离心泵和 Hico Variotherm 555 热交换器进行。从 2009 年 10 月至 2019 年 5 月,571 名患者,185 名(32%)新生儿,95 名(17%)儿科患者和 291 名(51%)成人患者接受了移动 ECMO 转运用途。453 次(79%)转运用公路完成,76 次(13%)用航空,42 次(8%)用公路/航空组合。对于预计单程时间不超过 3 小时的行程,首选公路旅行方式。尽管如此,安全地完成了长达 6 小时的公路转运用途。移动 ECMO 转运用途的平均时间为 5.5 小时(2-18 小时)。两名患者在移动 ECMO 团队到达之前死亡,四名患者在心肺复苏过程中接受置管,其中一名患者因右侧胸腔无法控制的出血而死亡。一名患者在 V-V 置管后出现心脏骤停,需要转换为 V-A。移动 ECMO 是安全可靠的,可转运病情最危重的患者。拥有全部设备和一次性用品的训练有素的团队是可靠的移动 ECMO 服务的必备条件。