Interhospital Transport System for Critically Ill Patients: Mobile Extracorporeal Membrane Oxygenation without a Ventilator.
10.5090/kjtcs.2017.50.1.8
- Author:
Hye Ju YEO
1
;
Woo Hyun CHO
;
Jong Myung PARK
;
Dohyung KIM
Author Information
1. Department of Pulmonology and Critical Care Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Extracorporeal membrane oxygenation;
Acute respiratory distress syndrome (ARDS);
Patient transfer;
Emergency medical system
- MeSH:
Ambulances;
Critical Illness*;
Emergency Medical Services;
Extracorporeal Membrane Oxygenation*;
Heart;
Humans;
Korea;
Lung;
Lung Diseases, Interstitial;
Lung Transplantation;
Methods;
Patient Transfer;
Respiration, Artificial;
Respiratory Distress Syndrome, Adult;
Retrospective Studies;
Transportation;
Ventilators, Mechanical*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2017;50(1):8-13
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services. METHODS: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015. We retrospectively analyzed the indications for ECMO, the patient status during transport, and the patient outcomes. RESULTS: All transport was conducted on the ground by ambulance. The distances covered ranged from 26 to 408 km (mean, 65.9±88.1 km) and the average transport time was 56.1±57.3 minutes (range, 30 to 280 minutes). All patients were transported without adverse events. After transport, 4 patients (22.2%) underwent lung transplantation because of interstitial lung disease. Eight patients who had severe acute respiratory distress syndrome showed recovery of heart and lung function after ECMO therapy. A total of 13 patients (70.6%) were successfully taken off ECMO, and 11 patients (61.1%) survived. CONCLUSION: Our ECMO transport system without mechanical ventilation can be considered a safe and useful method for interhospital transport and could be a good alternative option for ECMO transport in Korean hospitals with limited resources.
