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Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
Intrahospital transport of children on extracorporeal membrane oxygenation: indications, process, interventions, and
Parthak Prodhan1, Richard T Fiser, Sophia Cenac
1Arkansas Children's Hospital, Little Rock, AR, USA. prodhanparthak@uams.edu
Insights
Transporting critically ill patients on extracorporeal membrane oxygenation (ECMO) within the hospital is safe and effective. This first-of-its-kind study shows ECMO transport yields significant diagnostic and therapeutic benefits with no major complications.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Cardiovascular Surgery
Background:
- Critically ill patients requiring extracorporeal membrane oxygenation (ECMO) often need intrahospital transport for diagnostic and therapeutic procedures.
- Systematic evaluations of intrahospital transport safety and efficacy for ECMO patients are lacking.
- Intrahospital transport involves moving patients between intensive care units, operating rooms, and specialized diagnostic suites.
Purpose of the Study:
- To evaluate the indications, process, interventions, and effectiveness of intrahospital transport for patients on ECMO.
- To assess the safety and diagnostic/therapeutic yields of these transports.
- To establish a baseline for future research on ECMO patient transport.
Main Methods:
- Retrospective cohort analysis of 57 intrahospital transports.
- Patients on ECMO requiring transport between January 1996 and March 2007 were included.
- Analysis focused on indications, procedures, and outcomes.
Main Results:
- Transports were primarily for cardiac catheterization and head CT scans.
- Cardiac catheterization led to management changes in 70% of cases.
- Head CT scans identified significant pathology, prompting management changes.
- No major complications occurred during transport.
Conclusions:
- Intrahospital transport of ECMO patients is feasible and safe when performed by experienced teams.
- These transports provide significant diagnostic and therapeutic benefits.
- This study is the first to systematically evaluate the safety and efficacy of intrahospital transport for ECMO patients.
Objective:
To evaluate indications, process, interventions, and effectiveness of patients undergoing intrahospital transport. Critically ill patients supported with extracorporeal membrane oxygenation are transported within the hospital to the radiology suite, cardiac catheterization suite, operating room, and from one intensive care unit to another. No studies to date have systematically evaluated intrahospital transport for patients on extracorporeal membrane oxygenation.
Design:
Retrospective cohort analysis.
Setting:
Cardiac intensive care unit in a tertiary care children's hospital.
Patients:
All patients on extracorporeal membrane oxygenation who required intrahospital transport between January 1996 and March 2007 were included and analyzed.
Measurements And Main Results:
A total of 57 intrahospital transports for cardiac catheterization and head computed tomography scans were analyzed. In 14 (70%) of 20 of patients with cardiac catheterization, a management change occurred as a result of the diagnostic cardiac catheterization. In ten (59%) of 17 patients, bedside echocardiography was of limited value in defining the critical problem. In the interventional group, the majority of transports were for atrial septostomy. In the head computed tomography group, significant pathology was identified, which led to management change. No major complications occurred during these intrahospital transports.
Conclusions:
Although transporting patients on extracorporeal membrane oxygenation is labor intensive and requires extensive logistic support, it can be carried out safely in experienced hands and it can result in important therapeutic and diagnostic yields. To our knowledge, this is the first study designed to evaluate safety and efficacy of intrahospital transport for patients receiving extracorporeal membrane oxygenation support.
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