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The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation
INTRODUCTION: In severe respiratory and/or circulatory failure, extracorporeal membrane oxygenation (ECMO) may be a lifesaving procedure. Specialized departments provide ECMO, and these patients often have to be transferred for treatment. Conventional transportation is hazardous, and deaths have bee...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498561/ https://www.ncbi.nlm.nih.gov/pubmed/26160033 http://dx.doi.org/10.1186/s13054-015-0994-6 |
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author | Broman, L. Mikael Holzgraefe, Bernhard Palmér, Kenneth Frenckner, Björn |
author_facet | Broman, L. Mikael Holzgraefe, Bernhard Palmér, Kenneth Frenckner, Björn |
author_sort | Broman, L. Mikael |
collection | PubMed |
description | INTRODUCTION: In severe respiratory and/or circulatory failure, extracorporeal membrane oxygenation (ECMO) may be a lifesaving procedure. Specialized departments provide ECMO, and these patients often have to be transferred for treatment. Conventional transportation is hazardous, and deaths have been described. Only a few centers have performed more than 100 ECMO transports. To date, our mobile ECMO teams have performed more than 700 transports with patients on ECMO since 1996. We describe 4 consecutive years (2010–2013) of 322 national and international ECMO transports and report adverse events. METHODS: Data were retrieved from our local databases. Neonatal, pediatric and adult patients were transported, predominantly with refractory severe respiratory failure. RESULTS: The patients were cannulated in 282 of the transports, and ECMO was started in these patients at the referring hospital and then they were transported to our ECMO intensive care unit. In 40 cases, the patient was already on ECMO. Of the transports, 60 % were by aircraft, and the distances varied from 6.9 to 13,447 km. In about 27.3 % of the transports, adverse events occurred. Of these, the most common were either patient-related (22 %) or equipment-related (5.3 %). No deaths occurred during transport, and transferred patients exhibited the same mortality rate as in-hospital patients. CONCLUSIONS: Long- and short-distance interhospital transports on ECMO can be safely performed. A myriad of complications can occur, but the mortality risk is very low. The staff involved should be highly competent in intensive care, ECMO physiology and physics, cannulation, intensive care transport and air transport medicine. They should also be skilled in recognition of risk factors involved in these patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-015-0994-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4498561 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44985612015-07-11 The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation Broman, L. Mikael Holzgraefe, Bernhard Palmér, Kenneth Frenckner, Björn Crit Care Research INTRODUCTION: In severe respiratory and/or circulatory failure, extracorporeal membrane oxygenation (ECMO) may be a lifesaving procedure. Specialized departments provide ECMO, and these patients often have to be transferred for treatment. Conventional transportation is hazardous, and deaths have been described. Only a few centers have performed more than 100 ECMO transports. To date, our mobile ECMO teams have performed more than 700 transports with patients on ECMO since 1996. We describe 4 consecutive years (2010–2013) of 322 national and international ECMO transports and report adverse events. METHODS: Data were retrieved from our local databases. Neonatal, pediatric and adult patients were transported, predominantly with refractory severe respiratory failure. RESULTS: The patients were cannulated in 282 of the transports, and ECMO was started in these patients at the referring hospital and then they were transported to our ECMO intensive care unit. In 40 cases, the patient was already on ECMO. Of the transports, 60 % were by aircraft, and the distances varied from 6.9 to 13,447 km. In about 27.3 % of the transports, adverse events occurred. Of these, the most common were either patient-related (22 %) or equipment-related (5.3 %). No deaths occurred during transport, and transferred patients exhibited the same mortality rate as in-hospital patients. CONCLUSIONS: Long- and short-distance interhospital transports on ECMO can be safely performed. A myriad of complications can occur, but the mortality risk is very low. The staff involved should be highly competent in intensive care, ECMO physiology and physics, cannulation, intensive care transport and air transport medicine. They should also be skilled in recognition of risk factors involved in these patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-015-0994-6) contains supplementary material, which is available to authorized users. BioMed Central 2015-07-09 2015 /pmc/articles/PMC4498561/ /pubmed/26160033 http://dx.doi.org/10.1186/s13054-015-0994-6 Text en © Broman et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Broman, L. Mikael Holzgraefe, Bernhard Palmér, Kenneth Frenckner, Björn The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
title | The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
title_full | The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
title_fullStr | The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
title_full_unstemmed | The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
title_short | The Stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
title_sort | stockholm experience: interhospital transports on extracorporeal membrane oxygenation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498561/ https://www.ncbi.nlm.nih.gov/pubmed/26160033 http://dx.doi.org/10.1186/s13054-015-0994-6 |
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