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Safe transport of critically ill adult patients on extracorporeal membrane oxygenation support to a regional extracorporeal membrane oxygenation center.
ASAIO J. 2011 Sep-Oct; 57(5):421-5.AJ

Abstract

Patients with severe cardiac or pulmonary failure who require transport to specialized hospitals currently pose a challenge. Mechanical support in the form of extracorporeal membrane oxygenation (ECMO) may increase the safety of transporting such patients to an institution where they will have access to advanced medical therapy. Over 2.5 years, 17 patients were successfully cannulated and placed on a simplified ECMO circuit at other institutions and transported via ambulance to our hospital. Fourteen patients with acute respiratory distress syndrome (ARDS) were placed on venovenous (VV) ECMO. Two patients with isolated cardiogenic shock and one patient with ARDS were placed on venoarterial (VA) ECMO. The two cardiogenic shock patients were converted to a biventricular assist device shortly after arrival. The median unit-to-unit transport time was 60 minutes (interquartile range 50-92 minutes), and the median distance traveled was 23 miles (interquartile range 17-55 miles). There was no transport-related morbidity or mortality. The median duration of ECMO support was 8 days (interquartile range 4-11 days). Thirteen patients (76%) were successfully decannulated. Ten patients (59%) were weaned from the ventilator, and nine patients (53%) survived up to 3 months and were discharged from the hospital. Critically ill patients with severe ARDS or cardiogenic shock can be safely transported on VV or VA ECMO support to regional ECMO centers. As the indications and demands for ECMO support expand, so will the role for transporting patients on ECMO.

Authors+Show Affiliations

Division of Cardiothoracic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York City, New York, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21869618

Citation

Javidfar, Jeffrey, et al. "Safe Transport of Critically Ill Adult Patients On Extracorporeal Membrane Oxygenation Support to a Regional Extracorporeal Membrane Oxygenation Center." ASAIO Journal (American Society for Artificial Internal Organs : 1992), vol. 57, no. 5, 2011, pp. 421-5.
Javidfar J, Brodie D, Takayama H, et al. Safe transport of critically ill adult patients on extracorporeal membrane oxygenation support to a regional extracorporeal membrane oxygenation center. ASAIO J. 2011;57(5):421-5.
Javidfar, J., Brodie, D., Takayama, H., Mongero, L., Zwischenberger, J., Sonett, J., & Bacchetta, M. (2011). Safe transport of critically ill adult patients on extracorporeal membrane oxygenation support to a regional extracorporeal membrane oxygenation center. ASAIO Journal (American Society for Artificial Internal Organs : 1992), 57(5), 421-5. https://doi.org/10.1097/MAT.0b013e3182238b55
Javidfar J, et al. Safe Transport of Critically Ill Adult Patients On Extracorporeal Membrane Oxygenation Support to a Regional Extracorporeal Membrane Oxygenation Center. ASAIO J. 2011 Sep-Oct;57(5):421-5. PubMed PMID: 21869618.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safe transport of critically ill adult patients on extracorporeal membrane oxygenation support to a regional extracorporeal membrane oxygenation center. AU - Javidfar,Jeffrey, AU - Brodie,Daniel, AU - Takayama,Hiroo, AU - Mongero,Linda, AU - Zwischenberger,Joseph, AU - Sonett,Joshua, AU - Bacchetta,Matthew, PY - 2011/8/27/entrez PY - 2011/8/27/pubmed PY - 2012/1/24/medline SP - 421 EP - 5 JF - ASAIO journal (American Society for Artificial Internal Organs : 1992) JO - ASAIO J VL - 57 IS - 5 N2 - Patients with severe cardiac or pulmonary failure who require transport to specialized hospitals currently pose a challenge. Mechanical support in the form of extracorporeal membrane oxygenation (ECMO) may increase the safety of transporting such patients to an institution where they will have access to advanced medical therapy. Over 2.5 years, 17 patients were successfully cannulated and placed on a simplified ECMO circuit at other institutions and transported via ambulance to our hospital. Fourteen patients with acute respiratory distress syndrome (ARDS) were placed on venovenous (VV) ECMO. Two patients with isolated cardiogenic shock and one patient with ARDS were placed on venoarterial (VA) ECMO. The two cardiogenic shock patients were converted to a biventricular assist device shortly after arrival. The median unit-to-unit transport time was 60 minutes (interquartile range 50-92 minutes), and the median distance traveled was 23 miles (interquartile range 17-55 miles). There was no transport-related morbidity or mortality. The median duration of ECMO support was 8 days (interquartile range 4-11 days). Thirteen patients (76%) were successfully decannulated. Ten patients (59%) were weaned from the ventilator, and nine patients (53%) survived up to 3 months and were discharged from the hospital. Critically ill patients with severe ARDS or cardiogenic shock can be safely transported on VV or VA ECMO support to regional ECMO centers. As the indications and demands for ECMO support expand, so will the role for transporting patients on ECMO. SN - 1538-943X UR - https://www.unboundmedicine.com/medline/citation/21869618/Safe_transport_of_critically_ill_adult_patients_on_extracorporeal_membrane_oxygenation_support_to_a_regional_extracorporeal_membrane_oxygenation_center_ L2 - https://doi.org/10.1097/MAT.0b013e3182238b55 DB - PRIME DP - Unbound Medicine ER -