Transportation of patients with severe respiratory failure on ECMO support. Four-year experience of a single
ECMO center

Rypulak, Elżbieta; Szczukocka, Marta; Zyzak, Klaudia; Piwowarczyk, Paweł; Borys, Michał; Czuczwar, Mirosław

doi:10.5114/ait.2020.94501

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…The rate of complications during transport varies with the parameters utilized to define and identify them, as high as 20%–30% in some studies. The most common adverse events being loss of tidal volume, desaturation to less than 90% by pulse oximetry, air in return line, circulatory instability, hypovolemia, and device‐related bleeding 23–27 …”

Section: Discussionmentioning

confidence: 99%

“…The most common adverse events being loss of tidal volume, desaturation to less than 90% by pulse oximetry, air in return line, circulatory instability, hypovolemia, and device-related bleeding. [23][24][25][26][27] There are also risks inherent to the initiation of ECLS support. The most likely complications vary with the cannula configuration utilized and which proactive steps are taken to mitigate these issues.…”

Section: Interhospital Transfer On Eclsmentioning

confidence: 99%

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A model for delivery of extracorporeal life support in a stand‐alone veterans affairs medical center

Seadler,

Melamed,

Sow

et al. 2024

Artificial Organs

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IntroductionFor the Veterans Health Administration (VHA) to continue to perform complex cardiothoracic surgery, there must be an established pathway for providing urgent/emergent extracorporeal life support (ECLS). Partnership with a nearby tertiary care center with such expertise may be the most resource‐efficient way to provide ECLS services to patients in post‐cardiotomy cardiogenic shock or respiratory failure. The goal of this project was to assess the efficiency, safety, and outcomes of surgical patients who required transfer for perioperative ECLS from a single stand‐alone Veterans Affairs Medical Center (VAMC) to a separate ECLS center.MethodsCohort consisted of all cardiothoracic surgery patients who experienced cardiogenic shock or refractory respiratory failure at the local VAMC requiring urgent or emergent institution of ECLS between 2019 and 2022. The primary outcomes are the safety and timeliness of transport.ResultsMean time from the initial shock call to arrival at the ECLS center was 2.8 h. There were no complications during transfer. Six patients (86%) survived to decannulation.ConclusionThese results suggest that complex cardiothoracic surgery can be performed within the VHA system and when there is an indication for ECLS, those services can be safely and effectively provided at an affiliated, properly equipped center.

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Section: Discussionmentioning

confidence: 99%

Section: Interhospital Transfer On Eclsmentioning

confidence: 99%

A model for delivery of extracorporeal life support in a stand‐alone veterans affairs medical center

Seadler,

Melamed,

Sow

et al. 2024

Artificial Organs

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show abstract

“…Compared to patients treated with VV-ECMO because of AH1N1 ARDS, mortality in the entire analysed group was higher [ 15 ]. Rare but serious complications like stroke or cerebral haemorrhage were recognised complications (6 patients; 9.8%).…”

Section: Discussionmentioning

confidence: 99%

Utilisation and outcomes of a mobile (ambulance and air transport) venovenous extracorporeal membrane oxygenation (VV-ECMO) program in Poland during the COVID-19 pandemic – a retrospective, two-centres, case-series study

Rypulak,

Szczukocka,

Czarnik

2024

ait

Self Cite

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Most SARS-CoV-2 infections resulting in COVID-19 are asymptomatic or mild. Nevertheless, some patients develop severe acute respiratory distress syndrome (ARDS). Incidence of COVID-19 pneumonia ranges widely [1,2]. Respiratory failure in COVID-19 pneumonia is often treated with prone positioning, oxygen supplementation with high flow nasal cannula (HFNO), non-invasive, and mechanical ventilation. However, during the pandemic, the massive increase in patients with respiratory failure result-

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“…Predictive value has been demonstrated for acid–base balance parameters or lactate concentration and its kinetics in ICU patients [ 2 , 3 , 4 , 5 , 6 , 7 , 8 ], including those with septic shock, unstable haemodynamics, cardiac arrest, urgency laparotomy, and patients requiring ECMO support during transportation [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Admission Lactate Concentration, Base Excess, and Alactic Base Excess Predict the 28-Day Inward Mortality in Shock Patients

Smuszkiewicz

Jawień

Szrama

et al. 2022

JCM

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Base excess (BE) and lactate concentration may predict mortality in critically ill patients. However, the predictive values of alactic BE (aBE; the sum of BE and lactate), or a combination of BE and lactate are unknown. The study aimed to investigate whether BE, lactate, and aBE measured on admission to ICU may predict the 28-day mortality for patients undergoing any form of shock. In 143 consecutive adults, arterial BE, lactate, and aBE were measured upon ICU admission. Receiver Operating Curve (ROC) characteristics and Cox proportional hazard regression models (adjusted to age, gender, forms of shock, and presence of severe renal failure) were then used to investigate any association between these parameters and 28-day mortality. aBE < −3.63 mmol/L was found to be associated with a hazard ratio of 3.19 (HR; 95% confidence interval (CI): 1.62–6.27) for mortality. Risk of death was higher for BE < −9.5 mmol/L (HR: 4.22; 95% CI: 2.21–8.05), particularly at lactate concentrations > 4.5 mmol/L (HR: 4.62; 95% CI: 2.56–8.33). A 15.71% mortality rate was found for the combined condition of BE > cut-off and lactate < cut-off. When BE was below but lactate above their respective cut-offs, the mortality rate increased to 78.91%. The Cox regression model demonstrated that the predictive values of BE and lactate were mutually independent and additive. The 28-day mortality in shock patients admitted to ICU can be predicted by aBE, but BE and lactate deliver greater prognostic value, particularly when combined. The clinical value of our findings deserves further prospective evaluation.

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Transportation of patients with severe respiratory failure on ECMO support. Four-year experience of a single ECMO center

Cited by 5 publications

References 19 publications

A model for delivery of extracorporeal life support in a stand‐alone veterans affairs medical center

A model for delivery of extracorporeal life support in a stand‐alone veterans affairs medical center

Utilisation and outcomes of a mobile (ambulance and air transport) venovenous extracorporeal membrane oxygenation (VV-ECMO) program in Poland during the COVID-19 pandemic – a retrospective, two-centres, case-series study

Admission Lactate Concentration, Base Excess, and Alactic Base Excess Predict the 28-Day Inward Mortality in Shock Patients

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