Considerations for inter-hospital extracorporeal cardiopulmonary support resuscitation and transport

The availability of commercial, pre-packaged extracorporeal cardiopulmonary support (ECPS) circuits, which are simplified for rapid set-up and priming, has made the intra-hospital resuscitation of moribund patients routine. The successful utilization of this technology in the emergent setting requires planning and the coordination of personnel familiar with the technology. Many issues must be addressed when a patient requiring life-sustaining support utilizing this technology at an outlying hospital, must be transported while on ECPS. After reducing the size and weight of the ECPS cart and obtaining Federal Aviation Administration approval for use during aeromedical transport, the Emanuel Hospital Mobile Surgical Transport Team (MSTT) was able to extend the use of emergency cardiopulmonary bypass to outlying medical facilities. The patients selected for transport, using ECPS, are a group of patients with a potentially survivable pathology unlikely to survive inter-hospital transport without such measures. This report describes our experience with inter-hospital transport of patients on ECPS with special emphasis on transport considerations.