Adverse Events during Inter-Hospital Transports on Extracorporeal Membrane Oxygenation

Abstract

If transporting on ECMO high-risk or sudden threat-of-life situations are inevitable and have to be dealt with immediately, sometimes within seconds. A well-trained staff and an experienced high-volume organization are recommended. Key words: extra corporeal membrane oxygenation; ECMO, transport; adverse event; complication.

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

“…On the other hand, it is the only way to go when evolving in most parts of the world where ECMO is not established. Today, well developed systems for mobile ECMO are run in the United Kingdom (19,20), Australia (2,21), Italy (10,22-24), France (25,26), Sweden (7,(27)(28)(29), and the USA (5,30-33). Regional differences may exist within the same country, and the situation in total is not as uniformly organized in Germany (34), France (35,36), Belgium (personal communication), or South Norway (37).…”

BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program

“…The ELSO Registry showed that minimum number of ECMO therapies to achieve good outcomes is six per year but more than 30 annual adult ECMO applications were associated with significantly lower mortality (25)(26)(27)(28)(29)(30)(31). The main mission of ELSO is to collect registry of ECMO treatments and provide guidelines associated with ECMO treatment, also for ECMO transport (24).…”

“…In Europe, there are several such centers (Rastatt, Karolinska, Bochum, Leicester) (25)(26)(27)(28)(29)(30)(31). Due to the lack of system solutions, comprehensive procedures, adequate training and the number of personnel as well as the lack of intensive care places, the potential of perfusion therapy in Poland is not fully utilized.…”

“…To improve outcomes of ECMO applications, the ELSO recommended to consolidate ECMO treatment to high-volume centers. The ELSO Registry showed that minimum number of ECMO therapies to achieve good outcomes is six per year but more than 30 annual adult ECMO applications were associated with significantly lower mortality (25)(26)(27)(28)(29)(30)(31). Therefore, the position of therapy in centralized dedicated centers is strongly promoted, rather than diversifying therapies in smaller regional units (25,30).…”

“…As in other provincial cities, there is a lack of adequate center in Poznań dedicated to extracorporeal therapy. In Europe, there are several such centers (Rastatt, Karolinska, Bochum, Leicester) (25)(26)(27)(28)(29)(30)(31). Therefore, the recommended solution seems to be the creation of a referral Regional Center for Artificial Life Support.…”