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。
