A 22-year experience in global transport extracorporeal membrane oxygenation

Coppola, Christopher P.; Tyree, Melissa; Larry, Karen; DiGeronimo, Robert

doi:10.1016/j.jpedsurg.2007.09.021

Cited by 110 publications

(72 citation statements)

References 19 publications

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“…It is more the local experience, climate, health care culture, and funding and resources that form how these teams finally will be organized, staffed etc. (2,15,23,24,30,31).…”

Section: Overview and Resultsmentioning

confidence: 99%

Inter-hospital transports on extracorporeal membrane oxygenation in different health-care systems

Broman

2017

J. Thorac. Dis.

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“…It is more the local experience, climate, health care culture, and funding and resources that form how these teams finally will be organized, staffed etc. (2,15,23,24,30,31).…”

Section: Overview and Resultsmentioning

confidence: 99%

Inter-hospital transports on extracorporeal membrane oxygenation in different health-care systems

Broman

2017

J. Thorac. Dis.

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“…The use of this miniature portable ECMO machine was made necessary by the significantly limited physical space in the aircraft used for transport. Previous authors have reported use of military aircraft with associated larger space for equipment and crew (10). The Hawker jets and EC-145 helicopters used by our team are more confined.…”

Section: Procedures Developmentmentioning

confidence: 89%

“…Interfacility transport of ECMO-supported patients has been described in several published series over the last couple decades (10,12,13). In general ECMO transport is associated with low rates of complications and very low rates of significant complications.…”

Section: Discussionmentioning

confidence: 99%

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Development of a new interfacility extracorporeal membrane oxygenation transport program for pediatric lung transplantation evaluation

2017

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Pediatric lung transplantation is a life-saving intervention for children with irreversible endstage lung disease. Access to transplant can be limited by geographic isolation from a center or the presence of comorbidities affecting transplant eligibility. Extracorporeal membrane oxygenation (ECMO)-supported patients are an uncommon but historically high-risk cohort of patients considered for lung transplant. We report the development of a service at our center to provide transport services to our hospital for patients unable to wean from ECMO support at their local institution for the purpose of evaluation for lung transplantation by our program. We developed a process for pre-transport consultation by the lung transplant physician team, standardized hand-off tools and equipment lists, and procedures for transitioning patients to transport ECMO machinery. Four patients have been transported to date including fixed wing (FW) and helicopter transports. All patients were successfully transported with either none or minor complications. Transport of ECMO-supported patients is a feasible method to increase access of patients with irreversible lung injured patients to evaluation for lung transplant.

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“…It is unknown from the published report whether this was echocardiographically guided. As mentioned previously, transport with the device is more comparable with an IABP transfer than an ECMO transfer, which can be fraught with potential in-flight complications (13,14). Air transport of patients with an IABP in place has been successfully performed for the past 20 years (15).…”

Section: Discussionmentioning

confidence: 99%

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support

Guirgis

Kumar

Zieroth

et al. 2010

Canadian Journal of Cardiology

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C urrent hospital administrative practices categorize health care centres in a network of spokes and hubs (1). The 'spokes' are primary care centres that offer immediate yet temporary life-sustaining therapies, and channel the most severe cases to centres or 'hubs' that can provide the long-term treatment not available at the spoke sites. In the setting of mechanical circulatory support, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres. The relatively lower technical requirements of the Impella Recover LP 5.0 LVAD (ABIOMED Inc, USA) translate into greater utilization by spoke centres for the treatment of cardiogenic shock (2,3). Based on a literature review, we report the first case demonstrating successful use of the Impella Recover LP 5.0 LVAD, implanted under local anesthetic, for the purpose of interprovincial spoke-to-hub transport in a bridge-to-bridge-to-transplant procedure. case presentationMr S is a 54-year-old man with a greater than 10-year history of nonischemic dilated cardiomyopathy and symptomatic congestive heart failure managed medically. Following a sudden onset of angina, he presented to his local rural hospital and was diagnosed with an anterior ST elevation myocardial infarction complicated by high-grade atrioventricular block. Following stabilization with dopamine (5 µg/kg/min to 15 µg/kg/min) and insertion of a transvenous pacing wire, the patient was transferred to a tertiary care centre with cardiac surgery onsite, approximately 2 h away. On arrival, the patient had a blood pressure of 86/69 mmHg, a heart rate of approximately 70 beats/min (paced), a respiratory rate of 18 breaths/min and a hemoglobin saturation of 95% on 5 L supplemental oxygen. He had an increased jugular venous pressure of approximately 5 cm to 6 cm, with cool and clammy extremities. The electrocardiogram demonstrated third-degree atrioventricular block with increasing frequency of nonsustained ventricular tachycardia. He underwent emergent percutaneous coronary catheterizaton and thrombectomy of his proximal left anterior descending artery, with the remaining coronary arteries essentially unremarkable. The culprit lesion was not stented due to the patient's severe acetylsalicylic acid allergy and the potential need for heart transplantation. Despite restoration of Thrombolysis in Myocardial Infarction 3 flow following the procedure, the patient required increasing circulatory support, at which time an intra-aortic balloon pump (IABP) was inserted. The documented left ventricular end-diastolic pressure at this time was 39 mmHg. In the hours following, despite the use of inotropic Current hospital administrative practices categorize health care centres in a network of 'spokes' (primary care centres) and 'hubs' (tertiary care centres). For the treatment of cardiogenic shock, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres nationwide and are, thus, only available to patients living in close proximit...

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A 22-year experience in global transport extracorporeal membrane oxygenation

Cited by 110 publications

References 19 publications

Inter-hospital transports on extracorporeal membrane oxygenation in different health-care systems

Inter-hospital transports on extracorporeal membrane oxygenation in different health-care systems

Development of a new interfacility extracorporeal membrane oxygenation transport program for pediatric lung transplantation evaluation

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support

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