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体外膜肺氧合系统预组装和储存的临床实践。

Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems.

机构信息

From the Department of Anesthesiology, University Hospital RWTH Aachen University, Aachen, Germany.

Department of Heart Surgery, University Hospital RWTH Aachen, Aachen, Germany.

出版信息

ASAIO J. 2024 Nov 1;70(11):979-986. doi: 10.1097/MAT.0000000000002232. Epub 2024 May 28.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b7b/11512623/7318d1a6e00d/mat-70-0979-g001.jpg

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