A 22-year experience in global transport extracorporeal membrane oxygenation
A 22-year experience in global transport extracorporeal membrane oxygenation
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DOI：
10.1016/j.jpedsurg.2007.09.021
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发表时间：
2008-01-01
影响因子：
2.4
通讯作者：
DiGeronimo, Robert
中科院分区：
文献类型：
--
作者：
Coppola, Christopher P.;Tyree, Melissa;DiGeronimo, Robert
背景/目的：转运体外膜氧合（ECMO）目前在12个中心可用。我们报告22年的经验，从唯一的设施提供全球运输ECMO。运输ECMO的适应症包括缺乏ECMO服务，无法常规运输，无法脱离体外循环，体外心肺复苏，以及需要将患者转移到ECMO以进行器官移植等专业服务。方法：回顾性分析1985年至2007年接受室内和运输ECMO的儿童的数据库。结果：68例患儿行移动性ECMO。56人通过体外氧合转移到我们的设施。其余12人被转移到两个外部地点。使用了地面车辆和固定翼飞机。运输距离为8 - 7500英里（13-12070公里），平均1380英里（2220公里）。进行了116次体外氧合。没有儿童在运输过程中死亡。运输ECMO后到出院的存活率为65%(44/68)，而对于室内ECMO，存活率为70%（81/116）。结论：运输ECMO是可行和有效的，生存率与室内ECMO相当。我们使用转运ECMO来帮助非ECMO中心肺衰竭的儿童，这些儿童吸入一氧化氮和高频通气没有改善。我们也转运了一名体外心肺复苏后的儿童，这可能代表了转运ECMO的新指征。运输ECMO通常是儿童的唯一选择过于不稳定的传统运输或那些已经在ECMO和需要在其他机构的专门服务，如器官移植。(C) 2008爱思唯尔公司版权所有。
Background/Purpose: Transport extracorporeal membrane oxygenation (ECMO) is currently available at 12 centers. We report a 22-year experience from the only facility providing global transport ECMO. Indications for transport ECMO include lack of ECMO services, inability to transport conventionally, inability to wean from cardiopulmonary bypass, extracorporeal cardiopulmonary resuscitation, and need to move a patient on ECMO for specialized services such as organ transplantation.Methods: Retrospective database review of children undergoing inhouse and transport ECMO from 1985 to 2007.Results: Sixty-eight children underwent transport ECMO. Fifty-six were transported on ECMO into our facility. The remaining 12 were moved between 2 outside locations. Ground vehicles and fixed-wing aircraft were used. Distance transported was 8 to 7500 miles (13-12070 km), mean 1380 miles (2220 kin). There were 116 inhouse ECMO runs. No child died during transport. Survival to discharge after transport ECMO was 65% (44/68) and, for inhouse ECMO, was 70% (81/116).Conclusions: Transport ECMO is feasible and effective, with survival rates comparable to inhouse ECMO. We have used transport ECMO to help children at non-ECMO centers with pulmonary failure who have not improved with inhaled nitric oxide and high-frequency ventilation. We have also transported a child after extracorporeal cardiopulmonary resuscitation, which may represent an emerging indication for transport ECMO. Transport ECMO often is the only option for children too unstable for conventional transport or those already on ECMO and requiring a specialized service at another facility, such as organ transplantation. (C) 2008 Elsevier Inc. All rights reserved.