Does a Mobile ECLS Program Reduce Mortality for Patients Transported for ECLS Therapy for Severe Acute Respiratory Failure?

作者：Gutsche Jacob T^*; Miano Todd A; Vemick William; Raiten Jesse; Bermudez Christian; Vallabjoysula Prashant; Milewski Karianna; Szeto Wilson; Fall Meghan Lane; Williams Matthew L; Patel Prakash; Mikkelsen Mark E; Chiu Cornel; Ramakrishna Harish; Canon Jeremy; Augoustides John G

来源：Journal of Cardiothoracic and Vascular Anesthesia, 2018, 32(3): 1137-1141.

DOI：10.1053/j.jvca.2017.08.050

• ECLS
• ECMO
• extracorporeal life support
• extracorporeal membrane oxygenation
• ARDS
• acute respiratory distress syndrome
• mobile ECMO
• mobile life support
• transport

Objective: To understand if mobile extracorporeal membrane oxygenation reduces patient mortality during and after transport of patients requiring extracorporeal membrane oxygenation for acute respiratory distress syndrome.
Design: Retrospective chart review.
Setting: University affiliated tertiary care hospitals.
Participants: Seventy-seven patients.
Interventions: Introduction of a mobile extracorporeal membrane oxygenation (ECMO) program designed to facilitate the implementation of ECMO at outside hospitals in patients too unstable for transport for ECMO.
Measurements and Main Results: The 28-day in-hospital mortality was significantly lower in the post-mobile group (12/51 [23.5%] v 12/24 [50%], adjusted risk difference: 28.6%, [95% CI 4.7-52.5, p = 0.011]).
Conclusions: These findings suggest that patients with severe acute respiratory failure who require transport to a referral center for extracorporeal life support may benefit from the availability of a mobile extracorporeal life support team.

• 出版日期2018-6