Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic*
Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic*
复制标题
制定合作计划，为大流行期间患有难治性低氧血症的成人提供体外膜氧合*
DOI：
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发表时间：
2011
影响因子：
4.1
通讯作者：
I. Cheifetz
中科院分区：
文献类型：
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作者：
D. Turner;W. L. Williford;M. A. Peters;Janice J. Thalman;Ian R. Shearer;R. Walczak;Michael Griffis;S. Olson;K. Sowers;J. Govert;N. MacIntyre;I. Cheifetz
目的：我们报道了在甲型h1n1流感大流行背景下，用于快速开发成人呼吸道体外膜氧合计划的过程，以应对照顾难治性低氧血症的年轻成人患者。设计：复杂医疗系统对公共卫生危机的跨学科反应。患者、干预措施、测量和主要结果：在ph1n1诱导的难治性急性呼吸窘迫综合征的年轻成人成功使用体外膜氧合后，在8周的时间内实施了成人静脉-静脉体外膜氧合计划。该计划的实施涉及在开发过程中至关重要的一些关键步骤，包括行政和机构支持、多学科领导和合作、广泛的跨学科教育倡议和实质性的技术修改。结论：在甲型h1n1流感大流行的背景下，成功开发了成人呼吸道体外膜氧合计划，以补充已建立的新生儿-儿科计划。该项目扩展整合了开发过程从头到尾所涉及的所有必要组件，并证实了医疗系统可以非常快速和成功地响应紧急医疗需求。
Objective: We report the process used to rapidly develop a collaborative adult respiratory extracorporeal membrane oxygenation program as a response to caring for young adult patients with refractory hypoxemia in the setting of the pH1N1 pandemic. Design: Interdisciplinary response of a complex medical system to a public health crisis. Patients, Interventions, Measurements, and Main Results: After the successful use of extracorporeal membrane oxygenation in young adults with pH1N1-induced acute respiratory distress syndrome refractory to conventional therapies, an adult venovenous extracorporeal membrane oxygenation program was implemented over an 8-wk period. Implementation of this program involved a number of key steps that were crucial in the development process, including administrative and institutional support, multidisciplinary leadership and collaboration, extensive interdisciplinary educational initiatives, and substantial technical modifications. Conclusions: In the setting of the pH1N1 influenza pandemic, an adult respiratory extracorporeal membrane oxygenation program was successfully developed to complement an established neonatal-pediatric program. This program expansion integrated all of the necessary components involved in the development process from start to finish and confirms that a healthcare system can respond very quickly and successfully to an urgent healthcare need.