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KMID : 0364020170500010008
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Korean Journal of Thoracic and Cardiovascular Surgery
2017 Volume.50 No. 1 p.8 ~ p.13
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Interhospital Transport System for Critically Ill Patients: Mobile Extracorporeal Membrane Oxygenation without a Ventilator
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Yeo Hye-Ju
Cho Woo-Hyun
Park Jong-Myung
Kim Do-Hyung
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Abstract
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Background: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services.
Methods: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015. We retrospectively analyzed the indications for ECMO, the patient status during transport, and the patient outcomes.
Results: All transport was conducted on the ground by ambulance. The distances covered ranged from 26 to 408 km (mean, 65.9±88.1 km) and the average transport time was 56.1±57.3 minutes (range, 30 to 280 minutes). All patients were transported without adverse events. After transport, 4 patients (22.2%) underwent lung transplantation because of interstitial lung disease. Eight patients who had severe acute respiratory distress syndrome showed recovery of heart and lung function after ECMO therapy. A total of 13 patients (70.6%) were successfully taken off ECMO, and 11 patients (61.1%) survived.
Conclusion: Our ECMO transport system without mechanical ventilation can be considered a safe and useful method for interhospital transport and could be a good alternative option for ECMO transport in Korean hospitals with limited resources.
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KEYWORD
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Extracorporeal membrane oxygenation, Acute respiratory distress syndrome (ARDS), Patient transfer, Emergency medical system
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