Acute Respiratory Failure Managed via Inter-Facility Transport for Extracorporeal Life Support: A 3-Year Experience.
Publication/Presentation Date
7-1-2019
Abstract
OBJECTIVES: The objectives of this study were as follows: (1) to describe a successful design for a mobile lung rescue program, focusing on challenges and resources required to support such a program, and (2) report short-term outcomes for patients placed on venovenous extracorporeal life support (VV-ECLS) by a transferring team before inter-facility transport to a specialized extracorporeal life support (ECLS) center.
DESIGN: This retrospective review and analysis used patient chart review to collect outcomes data and resource demand.
SETTING: A single institutional experience in an academic center in the United States.
PARTICIPANTS: Patient selection targeted the 75 patients who were placed on VV-ECLS for acute respiratory failure at an outside institution by the authors' team before transport from January 1, 2015, through December 31, 2017.
INTERVENTIONS: No intervention was made.
MEASUREMENTS AND MAIN RESULTS: Average time for dispatch and transfer was 4 hours and 10 minutes for ground and 3 hours and 30 minutes for air transport (p = 0.029). Demand was highest in winter, with 61% (46/75) of patients presenting from November through April, and daytime, with 73% (55/75) occurring from 8 am to 8 pm. Demand increased during the study period, with 21 patients in 2015, 24 in 2016, and 30 in 2017. Mortality was low, with 72% of patients surviving to discharge.
CONCLUSIONS: Herein a successful mobile lung rescue program for transfer to a regional ECLS center is described. These findings demonstrate bed availability during high census and presence of a physician for duration of transport. These challenges can be overcome and successful implementation can be made with low mortality, supporting the development of regional ECLS centers.
Volume
33
Issue
7
First Page
1865
Last Page
1870
ISSN
1532-8422
Published In/Presented At
McDonald, M. D., Laudanski, K., Vernick, W. J., Bhardawaj, A., Mackay, E., & Gutsche, J. T. (2019). Acute Respiratory Failure Managed via Inter-Facility Transport for Extracorporeal Life Support: A 3-Year Experience. Journal of cardiothoracic and vascular anesthesia, 33(7), 1865–1870. https://doi.org/10.1053/j.jvca.2018.10.026
Disciplines
Anesthesiology | Medicine and Health Sciences
PubMedID
30559066
Department(s)
Department of Anesthesiology
Document Type
Article