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Patient Safety during ECMO Transportation: Single Center Experience and Literature Review

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been proven to support in lifesaving rescue therapy. The best outcomes can be achieved in high-volume ECMO centers with dedicated emergency transport teams. AIM: The aim of this study was to analyze the safety of ECMO support during medical...

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Autores principales: Puslecki, Mateusz, Baumgart, Konrad, Ligowski, Marcin, Dabrowski, Marek, Stefaniak, Sebastian, Ladzinska, Malgorzata, Goszczynska, Ewa, Marcinkowski, Pawel, Olasinska-Wisniewska, Anna, Klosiewicz, Tomasz, Pawlak, Aleksander, Zielinski, Marcin, Puslecki, Lukasz, Podlewski, Roland, Szarpak, Lukasz, Jemielity, Marek, Perek, Bartlomiej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920709/
https://www.ncbi.nlm.nih.gov/pubmed/33688436
http://dx.doi.org/10.1155/2021/6633208
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author Puslecki, Mateusz
Baumgart, Konrad
Ligowski, Marcin
Dabrowski, Marek
Stefaniak, Sebastian
Ladzinska, Malgorzata
Goszczynska, Ewa
Marcinkowski, Pawel
Olasinska-Wisniewska, Anna
Klosiewicz, Tomasz
Pawlak, Aleksander
Zielinski, Marcin
Puslecki, Lukasz
Podlewski, Roland
Szarpak, Lukasz
Jemielity, Marek
Perek, Bartlomiej
author_facet Puslecki, Mateusz
Baumgart, Konrad
Ligowski, Marcin
Dabrowski, Marek
Stefaniak, Sebastian
Ladzinska, Malgorzata
Goszczynska, Ewa
Marcinkowski, Pawel
Olasinska-Wisniewska, Anna
Klosiewicz, Tomasz
Pawlak, Aleksander
Zielinski, Marcin
Puslecki, Lukasz
Podlewski, Roland
Szarpak, Lukasz
Jemielity, Marek
Perek, Bartlomiej
author_sort Puslecki, Mateusz
collection PubMed
description BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been proven to support in lifesaving rescue therapy. The best outcomes can be achieved in high-volume ECMO centers with dedicated emergency transport teams. AIM: The aim of this study was to analyze the safety of ECMO support during medical transfer on the basis of our experience developed on innovation cooperation and review of literature. METHODS: A retrospective analysis of our experience of all ECMO-supported patients transferred from regional hospital of the referential ECMO center between 2015 and 2020 was carried out. Special attention was paid to transportation-related mortality and morbidity. Moreover, a systematic review of the Medline, Embase, Cochrane, and Google Scholar databases was performed. It included the original papers published before the end of 2019. RESULTS: Twelve (5 women and 7 men) critically ill ECMO-supported patients with the median age of 33 years (2–63 years) were transferred to our ECMO center. In 92% (n = 11) of the cases venovenous and in 1 case, venoarterial supports were applied. The median transfer length was 45 km (5–200). There was no mortality during transfer and no serious adverse events occurred. Of note, the first ECMO-supported transfer had been proceeded by high-fidelity simulations. For our systematic review, 68 articles were found and 22 of them satisfied the search criteria. A total number of 2647 transfers were reported, mainly primary (90%) and as ground transportations (91.6%). A rate of adverse events ranged from 1% through 20% but notably only major complications were mentioned. The 4 deaths occurred during transport (mortality 0.15%). CONCLUSIONS: Our experiences and literature review showed that transportation for ECMO patients done by experienced staff was associated with low mortality rate but life-threatening adverse events might occur. Translational simulation is an excellent probing technique to improve transportation safety.
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spelling pubmed-79207092021-03-08 Patient Safety during ECMO Transportation: Single Center Experience and Literature Review Puslecki, Mateusz Baumgart, Konrad Ligowski, Marcin Dabrowski, Marek Stefaniak, Sebastian Ladzinska, Malgorzata Goszczynska, Ewa Marcinkowski, Pawel Olasinska-Wisniewska, Anna Klosiewicz, Tomasz Pawlak, Aleksander Zielinski, Marcin Puslecki, Lukasz Podlewski, Roland Szarpak, Lukasz Jemielity, Marek Perek, Bartlomiej Emerg Med Int Research Article BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been proven to support in lifesaving rescue therapy. The best outcomes can be achieved in high-volume ECMO centers with dedicated emergency transport teams. AIM: The aim of this study was to analyze the safety of ECMO support during medical transfer on the basis of our experience developed on innovation cooperation and review of literature. METHODS: A retrospective analysis of our experience of all ECMO-supported patients transferred from regional hospital of the referential ECMO center between 2015 and 2020 was carried out. Special attention was paid to transportation-related mortality and morbidity. Moreover, a systematic review of the Medline, Embase, Cochrane, and Google Scholar databases was performed. It included the original papers published before the end of 2019. RESULTS: Twelve (5 women and 7 men) critically ill ECMO-supported patients with the median age of 33 years (2–63 years) were transferred to our ECMO center. In 92% (n = 11) of the cases venovenous and in 1 case, venoarterial supports were applied. The median transfer length was 45 km (5–200). There was no mortality during transfer and no serious adverse events occurred. Of note, the first ECMO-supported transfer had been proceeded by high-fidelity simulations. For our systematic review, 68 articles were found and 22 of them satisfied the search criteria. A total number of 2647 transfers were reported, mainly primary (90%) and as ground transportations (91.6%). A rate of adverse events ranged from 1% through 20% but notably only major complications were mentioned. The 4 deaths occurred during transport (mortality 0.15%). CONCLUSIONS: Our experiences and literature review showed that transportation for ECMO patients done by experienced staff was associated with low mortality rate but life-threatening adverse events might occur. Translational simulation is an excellent probing technique to improve transportation safety. Hindawi 2021-02-22 /pmc/articles/PMC7920709/ /pubmed/33688436 http://dx.doi.org/10.1155/2021/6633208 Text en Copyright © 2021 Mateusz Puslecki et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Puslecki, Mateusz
Baumgart, Konrad
Ligowski, Marcin
Dabrowski, Marek
Stefaniak, Sebastian
Ladzinska, Malgorzata
Goszczynska, Ewa
Marcinkowski, Pawel
Olasinska-Wisniewska, Anna
Klosiewicz, Tomasz
Pawlak, Aleksander
Zielinski, Marcin
Puslecki, Lukasz
Podlewski, Roland
Szarpak, Lukasz
Jemielity, Marek
Perek, Bartlomiej
Patient Safety during ECMO Transportation: Single Center Experience and Literature Review
title Patient Safety during ECMO Transportation: Single Center Experience and Literature Review
title_full Patient Safety during ECMO Transportation: Single Center Experience and Literature Review
title_fullStr Patient Safety during ECMO Transportation: Single Center Experience and Literature Review
title_full_unstemmed Patient Safety during ECMO Transportation: Single Center Experience and Literature Review
title_short Patient Safety during ECMO Transportation: Single Center Experience and Literature Review
title_sort patient safety during ecmo transportation: single center experience and literature review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920709/
https://www.ncbi.nlm.nih.gov/pubmed/33688436
http://dx.doi.org/10.1155/2021/6633208
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