Cargando…

Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals

PURPOSE: Most extracorporeal membrane oxygenation (ECMO) cannulations are performed by cardiothoracic surgeons (CTS). Due to an increase in utilization of ECMO and limited availability of CTS, there is a mismatch between ECMO demand and CTS accessibility for remote cannulations. We report our intens...

Descripción completa

Detalles Bibliográficos
Autores principales: Mihu, Mircea R., Maybauer, Marc O., Cain, Kaitlyn, Swant, Laura V., Harper, Michael D., Schoaps, Robert S., Brewer, Joseph M., Sharif, Ammar, Benson, Clayne, El Banayosy, Ahmed M., El Banayosy, Aly
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481738/
https://www.ncbi.nlm.nih.gov/pubmed/37680617
http://dx.doi.org/10.3389/fmed.2023.1239006
_version_ 1785102040125407232
author Mihu, Mircea R.
Maybauer, Marc O.
Cain, Kaitlyn
Swant, Laura V.
Harper, Michael D.
Schoaps, Robert S.
Brewer, Joseph M.
Sharif, Ammar
Benson, Clayne
El Banayosy, Ahmed M.
El Banayosy, Aly
author_facet Mihu, Mircea R.
Maybauer, Marc O.
Cain, Kaitlyn
Swant, Laura V.
Harper, Michael D.
Schoaps, Robert S.
Brewer, Joseph M.
Sharif, Ammar
Benson, Clayne
El Banayosy, Ahmed M.
El Banayosy, Aly
author_sort Mihu, Mircea R.
collection PubMed
description PURPOSE: Most extracorporeal membrane oxygenation (ECMO) cannulations are performed by cardiothoracic surgeons (CTS). Due to an increase in utilization of ECMO and limited availability of CTS, there is a mismatch between ECMO demand and CTS accessibility for remote cannulations. We report our intensivist-led program’s experience in remote ECMO cannulations, retrievals, complications, and outcomes. MATERIALS AND METHODS: A prospective, single-center, observational study was performed on patients that required ECMO cannulation at the referring facilities and were transported to our institution between program initiation, on October 1, 2014 to September 30, 2022. Results were presented as mean ± SD, median (min – max) or number (%). RESULTS: Since program commencement, 305 patients were accepted for ECMO retrieval. Three hundred and three patients were placed on ECMO at the 47 referring hospitals among 5 states. In our study, 185 (61%) patients required veno-arterial ECMO and 115 (38%) were placed on veno-venous ECMO. Three patients (1%) were cannulated for veno-arteriovenous ECMO. Twenty patients were cannulated under cardio-pulmonary resuscitation. Most of the patients were transported by ambulance (79%), 14% by helicopter, and 7% by airplane. Six out of the 303 patients did not leave the referring facility. All patients that left the referring hospitals arrived safely to our institution. No major complications occurred in route. CONCLUSION: Our study’s findings indicate that non-CTS physicians can successfully cannulate and retrieve patients with a low complication profile.
format Online
Article
Text
id pubmed-10481738
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-104817382023-09-07 Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals Mihu, Mircea R. Maybauer, Marc O. Cain, Kaitlyn Swant, Laura V. Harper, Michael D. Schoaps, Robert S. Brewer, Joseph M. Sharif, Ammar Benson, Clayne El Banayosy, Ahmed M. El Banayosy, Aly Front Med (Lausanne) Medicine PURPOSE: Most extracorporeal membrane oxygenation (ECMO) cannulations are performed by cardiothoracic surgeons (CTS). Due to an increase in utilization of ECMO and limited availability of CTS, there is a mismatch between ECMO demand and CTS accessibility for remote cannulations. We report our intensivist-led program’s experience in remote ECMO cannulations, retrievals, complications, and outcomes. MATERIALS AND METHODS: A prospective, single-center, observational study was performed on patients that required ECMO cannulation at the referring facilities and were transported to our institution between program initiation, on October 1, 2014 to September 30, 2022. Results were presented as mean ± SD, median (min – max) or number (%). RESULTS: Since program commencement, 305 patients were accepted for ECMO retrieval. Three hundred and three patients were placed on ECMO at the 47 referring hospitals among 5 states. In our study, 185 (61%) patients required veno-arterial ECMO and 115 (38%) were placed on veno-venous ECMO. Three patients (1%) were cannulated for veno-arteriovenous ECMO. Twenty patients were cannulated under cardio-pulmonary resuscitation. Most of the patients were transported by ambulance (79%), 14% by helicopter, and 7% by airplane. Six out of the 303 patients did not leave the referring facility. All patients that left the referring hospitals arrived safely to our institution. No major complications occurred in route. CONCLUSION: Our study’s findings indicate that non-CTS physicians can successfully cannulate and retrieve patients with a low complication profile. Frontiers Media S.A. 2023-08-23 /pmc/articles/PMC10481738/ /pubmed/37680617 http://dx.doi.org/10.3389/fmed.2023.1239006 Text en Copyright © 2023 Mihu, Maybauer, Cain, Swant, Harper, Schoaps, Brewer, Sharif, Benson, El Banayosy and El Banayosy. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Mihu, Mircea R.
Maybauer, Marc O.
Cain, Kaitlyn
Swant, Laura V.
Harper, Michael D.
Schoaps, Robert S.
Brewer, Joseph M.
Sharif, Ammar
Benson, Clayne
El Banayosy, Ahmed M.
El Banayosy, Aly
Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals
title Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals
title_full Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals
title_fullStr Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals
title_full_unstemmed Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals
title_short Bridging the gap: safety and outcomes of intensivist-led ECMO retrievals
title_sort bridging the gap: safety and outcomes of intensivist-led ecmo retrievals
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481738/
https://www.ncbi.nlm.nih.gov/pubmed/37680617
http://dx.doi.org/10.3389/fmed.2023.1239006
work_keys_str_mv AT mihumircear bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT maybauermarco bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT cainkaitlyn bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT swantlaurav bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT harpermichaeld bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT schoapsroberts bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT brewerjosephm bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT sharifammar bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT bensonclayne bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT elbanayosyahmedm bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals
AT elbanayosyaly bridgingthegapsafetyandoutcomesofintensivistledecmoretrievals