体外膜肺氧合辅助危重患者院际转运27例临床经验

目的:总结我院ECMO团队实施体外膜肺氧合(ECMO)辅助重症患者院际转运的临床经验。方法:回顾性分析2017年2月—2021年4月期间我院ECMO团队在ECMO支持下实现院际转运的27例危重患者的临床资料。记录患者疾病种类、插管地点、插管方法、院际转运距离、转运方式、患者转运期间不良事件发生情况以及临床转归。结果:27例患者均由我院心外科ECMO团队在外院置管后转至本单位。其中男24例,女3例;平均年龄52.5岁;转运距离4~300 km。1例患者采用直升机转运,26例患者采用地面救护车转运。转运过程中无死亡事件发生,但发生8例不良事件。ECMO顺利撤机18例,患者顺利出院14例。结论:ECMO辅助下危重患者的院际转运是安全而有效的,充分而周密的准备工作可有助于减少ECMO转运途中不良事件的发生。

Experience of extracorporeal membrane oxygenation support for inter-hospital transport in 27 critically ill patients

Objective: To summarize the clinical experiences of extracorporeal membrane oxygenation(ECMO) for inter-hospital transport in critically ill patients. Methods: We collected the clinical data of 27 critically ill patients who were transferred by our ECMO team from February 2017 to April 2021 and retrospectively analyzed the disease types, intubation location, intubation methods, distance between hospitals, transportation mode, adverse events during transportation and prognosis. Results: All of the 27 patients were transferred to our department by ECMO support, with 24 males and 3 females, average 52.5 years old, transportation distance 4 to 300 km. One patient was transferred by helicopter, and 26 patients were transferred by ground ambulance. There was no death but 8 adverse events occurred during ECMO transportation, with 18 patients successfully withdrawn ECMO and 14 were discharged.Conclusion: The ECMO transportation is safe and effective for inter-hospital transport in critically ill patients. Adequate and careful preparations can be helpful to reduce the adverse events during ECMO transportation.