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大流行期间新型冠状病毒肺炎患者机构间体外膜肺氧合转运的实际考量与结果:梅奥诊所经验

Practical Considerations for and Outcomes of Interfacility ECMO Transfer of Patients With COVID-19 During a Pandemic: Mayo Clinic Experience.

作者信息

Sen Ayan, Blakeman Stephanie, DeValeria Patrick A, Peworski Dominique, Lanza Louis A, Downey Francis X, Alwardt Cory M, Dobberpuhl Jeffrey G, DeMarco Matthew, Callisen Hannelisa, Shively Jennifer, McKay Kelly, Singbartl Kai, Sell-Dottin Kristen A, D'Cunha Jonathan, Patel Bhavesh M

机构信息

Department of Critical Care Medicine, Mayo Clinic Arizona, Phoenix.

Department of Nursing, Mayo Clinic Arizona, Phoenix.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2021 Apr;5(2):525-531. doi: 10.1016/j.mayocpiqo.2021.02.004. Epub 2021 Mar 3.

Abstract

Interfacility transport of a critically ill patient with acute respiratory distress syndrome (ARDS) may be necessary for a higher level of care or initiation of extracorporeal membrane oxygenation (ECMO). During the COVID-19 pandemic, ECMO has been used for patients with severe ARDS with successful results. Transporting a patient after ECMO cannulation by the receiving facility brings forth logistic challenges, including availability of adequate personal protective equipment for the transport team and hospital capacity management issues. We report our designated ECMO transport team's experience of 5 patients with COVID-19-associated severe ARDS after cannulation at the referring facility. Focusing on transport-associated logistics, creation of checklists, and collaboration with emergency medical services partners is necessary for safe and good outcomes for patients while maintaining team safety.

摘要

对于患有急性呼吸窘迫综合征(ARDS)的危重症患者,为了获得更高水平的治疗或启动体外膜肺氧合(ECMO),可能需要进行机构间转运。在新冠疫情期间,ECMO已被用于治疗重症ARDS患者,并取得了成功。接收机构在患者进行ECMO插管后进行转运带来了后勤方面的挑战,包括为转运团队提供足够的个人防护设备以及医院容量管理问题。我们报告了我们指定的ECMO转运团队对5例在转诊机构插管后患有新冠相关重症ARDS患者的转运经验。关注与转运相关的后勤工作、制定检查表以及与紧急医疗服务合作伙伴协作,对于患者获得安全良好的治疗结果并同时保障团队安全而言是必要的。

相似文献

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Extracorporeal membrane oxygenation for acute respiratory distress syndrome.体外膜肺氧合治疗急性呼吸窘迫综合征
J Intensive Care. 2015 Jun 17;3:17. doi: 10.1186/s40560-015-0082-7. eCollection 2015.

本文引用的文献

1
Inter-hospital COVID ECMO air transportation.医院间 COVID-19 体外膜肺氧合转运。
Perfusion. 2021 May;36(4):358-364. doi: 10.1177/0267659120973843. Epub 2020 Nov 25.
8
Safe patient transport for COVID-19.新型冠状病毒肺炎患者的安全转运
Crit Care. 2020 Mar 18;24(1):94. doi: 10.1186/s13054-020-2828-4.
9
Adverse Events during Inter-Hospital Transports on Extracorporeal Membrane Oxygenation.体外膜肺氧合院际转运期间的不良事件
Prehosp Emerg Care. 2017 Jul-Aug;21(4):448-455. doi: 10.1080/10903127.2017.1282561. Epub 2017 Feb 6.

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