Transportation of Patients on Extracorporeal Membrane Oxygenation: a Tertiary Medical Center Experience and Systematic Review of the Literature

Overview

Journal Ann Intensive Care

Specialty Critical Care

Date 2017 Feb 9

PMID 28176223

Citations 10

Authors

Pedro Vitale Mendes

Cesar de Albuquerque Gallo

Bruno Adler Maccagnan Pinheiro Besen

Adriana Sayuri Hirota

Raquel de Oliveira Nardi

Edzangela Vasconcelos Dos Santos

Ho Yeh Li

Daniel Joelsons

Eduardo Leite Vieira Costa

Flavia Krepel Foronda

Luciano Cesar Pontes Azevedo

Marcelo Park

Affiliations

Soon will be listed here.

Abstract

Background: Utilization of extracorporeal membrane oxygenation (ECMO) has increased worldwide, but its use remains restricted to severely ill patients, and few referral centers are properly structured to offer this support. Inter-hospital transfer of patients on ECMO support can be life-threatening. In this study, we report a single-center experience and a systematic review of the available published data on complications and mortality associated with ECMO transportation.

Methods: We reported single-center data regarding complications and mortality associated with the transportation of patients on ECMO support. Additionally, we searched multiple databases for case series, observational studies, and randomized controlled trials regarding mortality of patients transferred on ECMO support. Results were analyzed independently for pediatric (under 12 years old) and adult populations. We pooled mortality rates using a random-effects model. Complications and transportation data were also described.

Results: A total of 38 manuscripts, including our series, were included in the final analysis, totaling 1481 patients transported on ECMO support. A total of 951 patients survived to hospital discharge. The pooled survival rates for adult and pediatric patients were 62% (95% CI 57-68) and 68% (95% CI 60-75), respectively. Two deaths occurred during patient transportation. No other complication resulting in adverse outcome was reported.

Conclusion: Using the available pooled data, we found that patient transfer to a referral institution while on ECMO support seems to be safe and adds no significant risk of mortality to ECMO patients.

Citing Articles

Prone transportation to an ECMO center.

Nikouline A, Del Sorbo L, Granton J Trends Anaesth Crit Care. 2024; 39:10-11.

PMID: 38620830 PMC: 8091736. DOI: 10.1016/j.tacc.2021.04.003.

Outcomes of Patients Transported in the Prone Position to a Regional Extracorporeal Membrane Oxygenation Center: A Retrospective Cohort Study.

Zhang T, Nikouline A, Riggs J, Nolan B, Pan A, Peddle M Crit Care Explor. 2023; 5(7):e0948.

PMID: 37492857 PMC: 10365187. DOI: 10.1097/CCE.0000000000000948.

ECMOLIFE intra-hospital transport in life-saving for pulmonary vein obstruction.

Condello I, Nasso G, Contegiacomo G, Solimando C, Balducci G, Scaringi D Surg Case Rep. 2023; 9(1):113.

PMID: 37341809 PMC: 10284764. DOI: 10.1186/s40792-023-01702-y.

Early computed tomography after extracorporeal cardiopulmonary resuscitation on in-hospital survival: a retrospective cohort study.

Tong H, Zhang X, Chen K, Hu W, Gu Q J Thorac Dis. 2023; 15(3):1258-1266.

PMID: 37065582 PMC: 10089888. DOI: 10.21037/jtd-23-43.

Adult ECMO in the En Route Care Environment: Overview and Practical Considerations of Managing ECMO Patients During Transport.

Sams V, Anderson J, Hunninghake J, Gonzales M Curr Trauma Rep. 2022; 8(4):246-258.

PMID: 36284567 PMC: 9584252. DOI: 10.1007/s40719-022-00245-1.

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