From the Department of Anesthesiology, University Hospital RWTH Aachen University, Aachen, Germany.
Department of Heart Surgery, University Hospital RWTH Aachen, Aachen, Germany.
ASAIO J. 2024 Nov 1;70(11):979-986. doi: 10.1097/MAT.0000000000002232. Epub 2024 May 28.
According to the Extracorporeal Life Support Organization (ELSO) guidelines, pre-assembled and already primed extracorporeal membrane oxygenation (ECMO) systems can be safely stored for up to 30 days under specific conditions. This study gives a detailed overview of existing pre-assembly practices. An anonymous online survey was conducted among chief perfusionists at German ECMO centers. Forty-four of a total of 83 ECMO centers (53%) completed the survey. Thirty-three percent do not preassemble ECMO systems. Seventy-seven percent (n = 34) reported having preassembled ECMO systems readily available (30% dry preassembly/20% wet preassembly/27% wet preassembly with circulation). Half of the participating centers (50%) reported having a standard operating procedure (SOP) and the majority (57%) of chief perfusionists expressed a need for an evidence-based SOP. A maximum storage time for wet preassembled ECMO systems is established in 88% of departments. On average, wet preassembled systems are discarded after 20 days, which is below the ELSO's safe limit of 30 days. Overall, this survey reveals a heterogeneous approach regarding the practice of provisioning preassembled ECMO systems. The demand for an evidence-based SOP for the preassembly and storing of ECMO systems becomes evident, necessitating the determination of hygienic standards, regular training, and a reliable maximum storage period.
根据体外生命支持组织 (ELSO) 的指南,预先组装并已预充的体外膜肺氧合 (ECMO) 系统在特定条件下可以安全储存长达 30 天。本研究详细介绍了现有的预组装实践。对德国 ECMO 中心的首席灌注师进行了匿名在线调查。在总共 83 个 ECMO 中心中,有 44 个(53%)完成了调查。33%的中心不进行 ECMO 系统预组装。77%(n=34)报告说有现成的预组装 ECMO 系统(30%干预组装/20%湿预组装/27%湿预组装加循环)。一半的参与中心(50%)有标准操作程序(SOP),大多数(57%)首席灌注师表示需要基于证据的 SOP。88%的科室为湿预组装 ECMO 系统建立了最大储存时间。平均而言,湿预组装系统在 20 天后被丢弃,低于 ELSO 规定的 30 天安全期限。总的来说,这项调查显示了在提供预组装 ECMO 系统方面存在着不同的方法。对 ECMO 系统预组装和储存的基于证据的 SOP 的需求变得明显,需要确定卫生标准、定期培训和可靠的最大储存期限。