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基于插管位置和转运方式的院际体外膜肺氧合转运患者的结局

Outcomes of Patients Undergoing Interfacility Extracorporeal Membrane Oxygenation Transfer Based on Cannulation Location and Mode of Transport.

作者信息

Wothe Jillian K, Bergman Zachary R, Kalland Krystina R, Peter Logan G, Lusczek Elizabeth R, Brunsvold Melissa E

机构信息

University of Minnesota, Medical School, Minneapolis, MN.

Department of Surgery, University of Minnesota, Minneapolis, MN.

出版信息

Crit Care Explor. 2022 Mar 28;4(4):e0664. doi: 10.1097/CCE.0000000000000664. eCollection 2022 Apr.

Abstract

UNLABELLED

As the use of extracorporeal membrane oxygenation (ECMO) expands, so has the need for interfacility transfer to ECMO centers. However, the impact of these transfers has not been fully studied. This study evaluates complications and inhospital mortality in adult patients treated with venovenous (V-V) ECMO based on institutional location of cannulation and mode of transport.

DESIGN

Retrospective cohort study.

SETTING

Large midwestern ECMO center.

PATIENTS

Adult patients receiving VV-ECMO.

INTERVENTIONS

Need for transfer to ECMO center following VV-ECMO cannulation.

MEASUREMENTS AND MAIN RESULTS

The study included 102 adult patients, 57% of which were cannulated at an outside institution prior to transfer. Of these, 60% were transported by ground, and the remainder were transported by air. Risk-adjusted logistic regression did not reveal any significant increase in odds for any complication or inhospital mortality between the groups based on location of cannulation or mode of transport.

CONCLUSIONS

This study supports the practice of interfacility ECMO transfer with no difference in outcomes or inhospital mortality based on institutional location of cannulation or mode of transport.

摘要

未标注

随着体外膜肺氧合(ECMO)的应用不断扩大,将患者转运至ECMO中心进行治疗的需求也在增加。然而,这些转运的影响尚未得到充分研究。本研究基于置管的机构地点和运输方式,评估接受静脉-静脉(V-V)ECMO治疗的成年患者的并发症和住院死亡率。

设计

回顾性队列研究。

地点

中西部大型ECMO中心。

患者

接受V-V ECMO治疗的成年患者。

干预措施

V-V ECMO置管后转至ECMO中心的需求。

测量指标和主要结果

该研究纳入了102例成年患者,其中57%在转至本中心之前已在外部机构完成置管。其中,60%通过地面转运,其余通过空中转运。风险调整后的逻辑回归分析显示,基于置管地点或运输方式分组,各组间任何并发症或住院死亡率的比值均无显著增加。

结论

本研究支持机构间ECMO转运的做法,且基于置管的机构地点或运输方式,结局或住院死亡率并无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35cd/8963824/6cba5f488522/cc9-4-e0664-g001.jpg

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