Haneya, Assad and Philipp, Alois and Foltan, Maik and Mueller, Thomas and Camboni, Daniele and Rupprecht, Leopold and Puehler, Thomas and Hirt, Stephan and Hilker, Michael and Kobuch, Reinhard and Schmid, Christof and Arlt, Matthias (2009) Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution. ANNALS OF SAUDI MEDICINE, 29 (2). pp. 110-114. ISSN 0256-4947,
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND AND OBJECTIVES: Critically ill patients with acute circulatory failure cannot be moved to other institutions unless stabilized by mechanical support systems. Extracorporeal heart and lung assist systems are increasingly used as a bridge to end-organ recovery or transplantation, and as an ultimate rescue tool in cardiopulmonary resuscitation. PATIENTS AND METHODS: From July 2001 to April 2008, we had 38 requests for extracorporeal support for interhospital transfer carried out by the air medical service. Respiratory failure was present in 29 patients, who were provided with pumpless extracorporeal lung assist (PECLA) or veno-venous extracorporeal membrane oxygenation (ECMO). Cardiac failure dominated in 9 patients, who underwent implantation of extracorporeal life support (ECLS). Underlying diseases were acute respiratory distress syndrome in 15 patients, pneumonia in 7, prior lung transplant status in 4, cardiogenic shock in 7, and septic shock in 4. RESULTS: All assist systems were connected via peripheral vessels by the Seldinger technique. Transport was uneventful in all cases with no technical failures. On arrival at the specialized care hospital, two patients had leg ischemia and underwent relocation of the arterial cannula. After a mean (SD) support of 5.1 (3.0) days for PECLA, 3.5 (2.9) days for ECLS, and 7.3 (5.8) days for ECMO, 60%, 66%, and 66% of patients, respectively, could be successfully weaned from the systems. Discharge rates were 45% for PECLA, 44% for ECLS, and 56% for ECMO. CONCLUSION: Our experience proves that minimized extracorporeal assist devices allow safe assistance of patients with isolated or combined heart and lung failure in need of interhospital transfer. Critically ill patients get a chance to reach a center of maximum medical care.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LUNG ASSIST; LIFE-SUPPORT; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 21 Sep 2020 09:13 |
| Last Modified: | 21 Sep 2020 09:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/29302 |
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