A case series report of extracorporeal membrane oxygenation support for inter-hospital transport to critically ill patients

Abstract

Objective To summerize the clinical outcomes and experience of extracorporeal membrane oxygenation (ECMO)-supported inter-hospital transport for critically ill patients. Methods Clinical data of 10 critically ill patients undergoing ECMO-supported inter-hospital transport by our ECMO team during June 2016 and January 2018 were collected in this study. The transport distance, transport complications and treatment outcomes were summarized. Results The transport distance of 10 cases was 3.4 to 248.0 km, at an average of 72.6 km. During the transportation, 1 case of V-V ECMO patients (drainage from the right femoral vein and reflux to the right internal jugular vein) had twist of venous tubes, which affected ECMO flow, and 2 cases of V-A ECMO patients (drainage from the right femoral vein and reflux to the right femoral artery) had incision bleeding. All of the 10 cases safely reached our hospital. One patient was cured and discharged, 1 was successfully removed from ECMO but died of pulmonary infection and multiple organ failure, 1 patient died, 2 patients discharged from hospital by themselves because their family finally gave up the treatment, and the left 5 patients became brain death donors for the liver and/or kidneys. Conclusion Inter-hospital transport on ECMO can be safely performed in critically ill patients, and the complications associated with ECMO transport can be controlled. The staffs involved should pay attention to the construction of ECMO multidisciplinary team and standardize the operating procedures.

Keywords

• extracorporeal membrane oxygenation
• extracorporeal life support system
• inter-hospital transport
• critically ill patients