Does a Mobile ECLS Program Reduce Mortality for Patients Transported for ECLS Therapy for Severe Acute Respiratory Failure?

被引:8
作者
Gutsche, Jacob T. [1 ]
Miano, Todd A. [2 ]
Vemick, William [1 ]
Raiten, Jesse [1 ]
Bermudez, Christian [3 ]
Vallabjoysula, Prashant [3 ]
Milewski, Karianna [3 ]
Szeto, Wilson [3 ]
Fall, Meghan Lane [1 ]
Williams, Matthew L. [3 ]
Patel, Prakash [1 ]
Mikkelsen, Mark E. [4 ]
Chiu, Cornel [5 ]
Ramakrishna, Harish [6 ]
Canon, Jeremy [7 ]
Augoustides, John G. [1 ]
机构
[1] Univ Penn Hlth Syst, Dept Anesthesiol & Crit Care, Philadelphia, PA USA
[2] Univ Penn, Ctr Clin Epidemiol & Biostat, Perelman Sch Med, Philadelphia, PA 19104 USA
[3] Univ Penn Hlth Syst, Dept Surg, Div Cardiovasc Surg, Philadelphia, PA USA
[4] Univ Penn Hlth Syst, Dept Med, Pulm Allergy & Crit Care Div, Philadelphia, PA USA
[5] Drexel Univ, Coll Med, Philadelphia, PA 19104 USA
[6] Mayo Clin, Dept Anesthesiol, Scottsdale, AZ USA
[7] Univ Penn Hlth Syst, Div Traumatol Surg Crit Care & Emergency Surg, Philadelphia, PA USA
关键词
ECLS; ECMO; extracorporeal life support; extracorporeal membrane oxygenation; ARDS; acute respiratory distress syndrome; mobile ECMO; mobile life support; transport; EXTRACORPOREAL MEMBRANE-OXYGENATION; 2009 INFLUENZA A(H1N1); DISTRESS-SYNDROME; LIFE-SUPPORT; VOLUME; ORGANIZATION; VENTILATION; EXPERIENCE; IMPACT;
D O I
10.1053/j.jvca.2017.08.050
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objective: To understand if mobile extracorporeal membrane oxygenation reduces patient mortality during and after transport of patients requiring extracorporeal membrane oxygenation for acute respiratory distress syndrome. Design: Retrospective chart review. Setting: University affiliated tertiary care hospitals. Participants: Seventy-seven patients. Interventions: Introduction of a mobile extracorporeal membrane oxygenation (ECMO) program designed to facilitate the implementation of ECMO at outside hospitals in patients too unstable for transport for ECMO. Measurements and Main Results: The 28-day in-hospital mortality was significantly lower in the post-mobile group (12/51 [23.5%] v 12/24 [50%], adjusted risk difference: 28.6%, [95% CI 4.7-52.5, p = 0.011]). Conclusions: These findings suggest that patients with severe acute respiratory failure who require transport to a referral center for extracorporeal life support may benefit from the availability of a mobile extracorporeal life support team. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:1137 / 1141
页数:5
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