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ECMO transport

Hussein D Kanji, Alexandra Chouldechova, Chris Harvey, Ephraim O'dea, Gail Faulkner, Giles Peek
There is little published data on the safety and effectiveness of mobile (inter-hospital) extra-corporeal membrane oxygenation (ECMO) in adults, particularly focusing on the cannulation strategy. We sought to study the outcomes of patients cannulated with a bicaval dual lumen catheter needing mobile compared to conventional ECMO. Specifically, we evaluated the safety of using this cannulation strategy during initiation, in transport and overall performance. Multivariate adjustment was performed to report on adjusted 6-month survival as well as complications and performance from cannulation and the ECMO run...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Nicholas S Boscamp, Mariel E Turner, Matthew Crystal, Brett Anderson, Julie A Vincent, Alejandro J Torres
Cardiac catheterization is commonly performed in patients being supported by extracorporeal membrane oxygenation (ECMO). We aimed to evaluate the safety, benefit, and outcomes of catheterization in pediatric patients supported by ECMO. Retrospective review of cardiac catheterizations performed in patients ≤18 years of age while on ECMO at a large tertiary care center between January 2000 and May 2015. A total of 55 catheterizations were performed on 51 patients during 53 unique ECMO courses. Indications for ECMO include ventricular dysfunction (22), cardiac arrest (20), inability to wean from cardiopulmonary bypass (7), and persistent cyanosis (4)...
November 21, 2016: Pediatric Cardiology
James Lantry, Jeffrey DellaVolpe, Valerie Sams, Matthew Hamm, Philip Mason
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Nao Umei, Shingo Ichiba, Masayuki Chida
As the Japanese organ donor allocation system does not permit the allocation of lungs at a priority level to patients on extracorporeal membrane oxygenation (ECMO), many of these patients die before suitable donor lungs become available. We report our first experience with ECMO as a bridge to lung transplantation (LTx) from a brain-dead donor. A 40-year-old man with interstitial lung disease who was listed for LTx 3 years previously, experienced progressive deterioration of respiratory function. He was mechanically ventilated at another hospital and was transported to our hospital due to severe hypoxemia...
November 9, 2016: General Thoracic and Cardiovascular Surgery
Adambeke Nwozuzu, Manuel L Fontes, Robert B Schonberger
OBJECTIVE: To evaluate differences in the inclusion of anesthesiologists in mobile extracorporeal membrane oxygenation (ECMO) teams between North American and European centers. DESIGN: A retrospective review of North American versus European mobile ECMO teams. The search terms used to identify relevant articles were the following: "extracorporeal membrane transport," "mobile ECMO," and "interhospital transport." SETTING: MEDLINE review of articles...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
Charles Marinus Pedersen, Reinhold Jensen, Christian Lindskov
Extracorporeal membrane oxygenation (ECMO) can support gas exchange independently of mechanical ventilation in patients with severe acute respiratory failure. Veno-venous ECMO is a temporary technique for providing life support by pulmonary dysfunction. ECMO should be considered for patients with respiratory failure when they cannot survive with conventional therapy. ECMO may be used either as a rescue therapy or to prevent ventilator-associated lung injury. Exact criteria for ECMO are not available. Transportation while using ECMO is safe when a team from the management centre provides it...
September 19, 2016: Ugeskrift for Laeger
Jerome Rambaud, Pierre L Léger, Ludovic Porlier, Michelle Larroquet, Herve Raffin, Charlotte Pierron, Herve Walti, Ricardo Carbajal
Refractory severe hemodynamic or respiratory failure may require extracorporeal membrane oxygenation (ECMO). Since some patients are too sick to be transported safely to a referral ECMO center on conventional transportation, mobile ECMO transport teams have been developed. The experiences of some ECMO transport teams have already been reported, including air and international transport. We report the first French pediatric international ECMO transport by aircraft. This case shows that a long distance intervention of the pediatric ECMO transport team is feasible, even in an international setting...
September 1, 2016: Perfusion
Kilian Brown, Ben Dunne, Marino Festa, Erik La Hei, Jonathan Karpelowsky, Hayden Dando, Yishay Orr
There is minimal reported experience with long-range retrieval of pediatric patients receiving extracorporeal membrane oxygenation (ECMO) support. We report the case of a 10-month old boy with necrotizing staphylococcal pneumonia complicated by a bronchopleural fistula, who was successfully retrieved and transported while receiving ECMO to our unit in Sydney, Australia, from a referring hospital 2,000 kilometers away in the Pacific Islands. He was successfully weaned from ECMO to receive single-lung ventilation after 13 days, and he underwent surgical repair of his bronchopleural fistula through a thoracotomy 3 days after decannulation...
August 2016: Annals of Thoracic Surgery
Demetris Yannopoulos, Jason A Bartos, Cindy Martin, Ganesh Raveendran, Emil Missov, Marc Conterato, R J Frascone, Alexander Trembley, Kevin Sipprell, Ranjit John, Stephen George, Kathleen Carlson, Melissa E Brunsvold, Santiago Garcia, Tom P Aufderheide
BACKGROUND: In 2015, the Minnesota Resuscitation Consortium (MRC) implemented an advanced perfusion and reperfusion life support strategy designed to improve outcome for patients with out-of-hospital refractory ventricular fibrillation/ventricular tachycardia (VF/VT). We report the outcomes of the initial 3-month period of operations. METHODS AND RESULTS: Three emergency medical services systems serving the Minneapolis-St. Paul metro area participated in the protocol...
June 2016: Journal of the American Heart Association
L Mikael Broman, Björn Frenckner
Extracorporeal membrane oxygenation (ECMO) may be a life-saving procedure for patients with severe reversible pulmonary or cardiac failure or for patients in need for a bridge to transplantation. ECMO is provided by specialized centers, but patients in need of ECMO are frequently taken care of at other centers. Conventional transports to an ECMO center can be hazardous and deaths have been described. For this reason, many ECMO centers have developed transport programs with mobile ECMO. After request, the mobile team including all necessary equipment to initiate ECMO is sent to the referring hospital, where the patient is cannulated and ECMO commenced...
2016: Frontiers in Pediatrics
Philip L Holt, Ashley B Hodge, Todd Ratliff, W Joshua Frazier, David Ohnesorge, Samantha W Gee
Indications for the use of extracorporeal membrane oxygenation (ECMO) in pediatrics has expanded beyond the initial historic treatment of neonates with respiratory failure. Patients with severe refractory cardiopulmonary failure may benefit from ECMO support until the primary insult has subsided or been treated. More recently, ECMO has been used by some centers as a bridge to transplant for irreversible organ failure. Nationwide Children's Hospital is a referral center that supports the use of ECMO as a bridge to transplant and is able to provide transport services for ECMO patients referred for transplant evaluation...
May 2016: Air Medical Journal
Hugo Kjellemo, Andreas E Hansen, Dennis A Øines, Thor O Nilsen, Lars Wik
Survival from pediatric cardiac arrest due to trauma has been reported to be 0.0%-8.8%. Some argue that resuscitation efforts in the case of trauma-related cardiac arrests are futile. We describe a successful outcome in the case of a child who suffered cardiac arrest caused by external traumatic airway obstruction. Our case illustrates how to deal with pediatric traumatic cardiac arrests in an out-of-hospital environment. It also illustrates how good clinical treatment in these situations may be supported by correct treatment after hospital admission when it is impossible to ventilate the patient to provide sufficient oxygen delivery to vital organs...
May 2016: Prehospital Emergency Care
B Frenckner
Extracorporeal membrane oxygenation (ECMO) is a method for providing long-term treatment of a patient in a modified heart-lung machine. Desaturated blood is drained from the patient, oxygenated and pumped back to a major vein or artery. ECMO supports heart and lung function and may be used in severe heart and/or lung failure when conventional intensive care fails. The Stockholm programme started in 1987 with treatment of neonates. In 1995, the first adult patient was accepted onto the programme. Interhospital transportation during ECMO was started in 1996, which enabled retrieval of extremely unstable patients during ECMO...
December 2015: Journal of Internal Medicine
Vanessa Moll, Elrond Y L Teo, David S Grenda, Cindy D Powell, Michael J Connor, Bryce T Gartland, Mary J Zellinger, H Bruce Bray, Christopher A Paciullo, Craig M Kalin, Jean M Wheeler, Duc Q Nguyen, James M Blum
Extracorporeal membrane oxygenation (ECMO) is an established therapy in the management of patients with refractory cardiogenic shock or acute respiratory failure. In this report, we describe the rapid development and implementation of an organized ECMO program at a facility that previously provided ad hoc support. The program provides care for patients within the Emory Healthcare system and throughout the Southeastern United States. From September 2014 to February 2015, 16 patients were treated with either venovenous or venoarterial ECMO with a survival to decannulation of 53...
May 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Darryl Abrams, Daniel Brodie
PURPOSE OF REVIEW: Despite advances in extracorporeal membrane oxygenation (ECMO) technology, much is unknown about the optimal management strategies for patients receiving extracorporeal support. There is a growing body of literature investigating patient selection and outcomes, mechanical ventilation approaches, anticoagulation, pharmacokinetics, early mobilization, and the role of ECMO transport among others. RECENT FINDINGS: Nonrandomized data suggest a survival advantage from ECMO compared with conventional management in acute respiratory distress syndrome, with mechanical ventilation practices varying widely across centers...
February 2016: Current Opinion in Critical Care
J Rambaud, P L Léger, M Larroquet, A Amblard, N Lodé, J Guilbert, S Jean, I Guellec, I Casadevall, K Kessous, H Walti, R Carbajal
No abstract text is available yet for this article.
May 2016: Intensive Care Medicine
Cory M Alwardt, Donald S Wilson, Michelle L Alore, Louis A Lanza, Patrick A Devaleria, Octavio E Pajaro
Extracorporeal membrane oxygenation (ECMO) is indicated when conventional measures fail to support a patient during cardiac or respiratory failure. Due to the complicated nature of ECMO, patients often require transport to a tertiary care center. This study retrospectively compared the performance of the Cardiohelp™ (Maquet) life support system with a previously used ECMO circuit when transporting adult patients on venoarterial ECMO between facilities. Two ECMO circuits were compared for performance: 1) the Cardiohelp™ (Maquet) life support system and 2) the "standard" circuit consisting of a Thoratec CentriMag centrifugal pump, Maquet Quadrox-D oxygenator, and a Terumo CDI-500 in-line blood gas analyzer...
March 2015: Journal of Extra-corporeal Technology
Ricky Vaja, Ishaan Chauhan, Vijay Joshi, Yousuf Salmasi, Richard Porter, Gail Faulkner, Chris Harvey
INTRODUCTION: Mobile extracorporeal membrane oxygenation (ECMO) is reserved for critically unstable patients who may not otherwise survive transfer to the ECMO center. We describe our experience with mobile ECMO. METHODS: We retrospectively reviewed adult patients between 2010 and 2014 who were referred for ECMO support and were too unwell for conventional transfer. They were cannulated at their referring center by our team and subsequently transported back to our hospital on ECMO...
December 2015: Journal of Critical Care
Rymbay Kaliyev, Timur Kapyshev, Alex Goncharov, Timur Lesbekov, Yuri Pya
Use of extracorporeal membrane oxygenation (ECMO) for severe cardiopulmonary failure has increased because of improved outcomes. A specially designed ECMO transport system allows for safe transport of patients over long distances. We report a 28-year-old pregnant woman (26 weeks gestation) with acute respiratory distress syndrome in whom ECMO support was necessary for survival, and she was transported to another facility 1,155 km away with the aid of the portable ECMO system. Transport was uneventful, and the patient's condition remained stable...
September 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Nicolas J Prat, Andrew D Meyer, Thomas Langer, Robbie K Montgomery, Bijaya K Parida, Andriy I Batchinsky, Andrew P Cap
BACKGROUND: Over 32% of burned battlefield causalities develop trauma-induced hypoxic respiratory failure, also known as acute respiratory distress syndrome (ARDS). Recently, 9 out of 10 US combat soldiers' survived life-threatening trauma-induced ARDS supported with extracorporeal membrane oxygenation (ECMO), a portable form of cardiopulmonary bypass. Unfortunately, the size, incidence of coagulation complications, and the need for systematic anticoagulation for traditional ECMO devices have prevented widespread use of this lifesaving technology...
December 2015: Shock
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