Objectives: Patients with severe acute respiratory distress syndrome may require veno-venous extracorporeal membrane oxygenation (V-V ECMO) support. For patients in peripheral hospitals, retrieval by mobile ECMO teams and transport to high-volume centers is associated with improved outcomes, including the recent COVID-19 pandemic. To enable a safe transport of patients, a specialised ECMO-retrieval program needs to be implemented. However, there is insufficient evidence on how to safely and efficiently perform ECMO retrievals. We report single-centre data from out-of-centre initiations of VV-ECMO before and during the COVID-19 pandemic.
Design & Setting: Single-centre retrospective study. We include all the retrievals performed by our ECMO centre between January 1st, 2014, and April 30th, 2021.
Results: One hundred ECMO missions were performed in the study period, for a median retrieval volume of 13 (IQR: 9-16) missions per year. the cause of the acute respiratory distress syndrome was COVID-19 in 10 patients (10 %). 98 (98 %) patients were retrieved and transported to our ECMO centre. To allow safe transport, 91 of them were cannulated on-site and transported on V-V ECMO. The remaining seven patients were centralised without ECMO, but they were all connected to V-V ECMO in the first 24 hours. No complications occurred during patient transport. The median duration of the ECMO mission was 7 hours (IQR: 6-9, range: 2 - 17). Median duration of ECMO support was 14 days (IQR: 9-24), whereas the ICU stay was 24 days (IQR:18-44). Overall, 73 patients were alive at hospital discharge (74 %). Survival rate was similar in non-COVID-19 and COVID-19 group (73 % vs 80 %, p = 0.549).
Conclusion: In this single-centre experience, before and during COVID-19 era, retrieval and ground transportation of ECMO patients was feasible and was not associated with complications. Key factors of an ECMO retrieval program include a careful selection of the transport ambulance, training of a dedicated ECMO mobile team and preparation of specific checklists and standard operating procedures.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9647026 | PMC |
| http://dx.doi.org/10.1016/j.iccn.2022.103350 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
pneumonia followed by lower gastrointestinal ischemic necrosis: a case report.
Front Med (Lausanne)
January 2025
Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Research Institute of Surgery, Chongqing, China.
Background: Psittacosis, also known as parrot fever, is an uncommon infectious disease caused by (C. psittaci). While infections are usually not life-threatening, the pathogenesis and associated complications are not yet fully understood.
View Article and Find Full Text PDFExtracorporeal membrane oxygenation for adults with respiratory failure secondary to cardiorespiratory disease: evolving indications and clinical practice.
Breathe (Sheff)
January 2025
Critical Care Unit, Royal Brompton Hospital, London, UK.
Extracorporeal membrane oxygenation (ECMO) can support patients with severe cardiorespiratory failure presenting with hypoxia who would otherwise have not survived. Patient selection for ECMO is challenging and relies on the integration of physiological variables with an assessment of reversibility of the underlying condition or suitability for transplantation. In this review, we focus on patients with cardiorespiratory disease who may present with severe hypoxia.
View Article and Find Full Text PDFPredictors of mortality in trauma patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation.
Surg Pract Sci
June 2022
University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, 333 The City Blvd West, Suite 1600, Orange, CA 92868-3298, USA.
Objective: Trauma-related Acute Respiratory Distress Syndrome (TR-ARDS) mortality ranges from 30 to 80%. Extracorporeal membrane oxygenation (ECMO) has demonstrated a survival benefit in select cases of TR-ARDS. In order to provide improved patient selection, we evaluated predictors of mortality in TR-ARDS patients receiving ECMO, hypothesizing age and severe thoracic trauma as risk factors for mortality.
View Article and Find Full Text PDFAwake Venovenous Extracorporeal Membrane Oxygenation in the Intensive Care Unit: Challenges and Emerging Concepts.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address:
Extracorporeal membrane oxygenation (ECMO) is an advanced treatment for severe respiratory failure. Implantation of ECMO before invasive ventilation or extubation during ECMO has been reported and is becoming increasingly popular. Avoidance of sedation and invasive ventilation during ECMO (commonly referred to as "awake ECMO") may have potential advantages, including a lower rate of delirium, shorter mechanical ventilation time, and the possibility of undergoing early rehabilitation and/or physiotherapy.
View Article and Find Full Text PDFVeno-venous ECMO intervention for respiratory failure after trauma from a motor vehicle collision.
BMJ Case Rep
January 2025
Department of General Surgery, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Queensland, Australia.
Extracorporeal membrane oxygenation (ECMO) has emerged as a salvage therapy in refractory respiratory failure. Within the literature, there is evidence to support the use of ECMO in severe thoracic trauma; however, there is minimal information on its applicability in mild to moderate thoracic trauma. This report describes a man in his 50s who suffered thoracic trauma following a motor vehicle accident, who, despite maximal medical therapy, experienced deterioration in respiratory function, requiring the commencement of veno-venous ECMO on day 5 post injury and subsequently achieved excellent functional recovery.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!