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One-Year Experience With a Mobile Extracorporeal Life Support Service
Jacob Gutsche1, William Vernick1, Todd A Miano2
1Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
The Annals of Thoracic Surgery
|July 4, 2017
Summary
A mobile extracorporeal life support (ECLS) program improved survival for severe acute respiratory distress syndrome patients requiring transport. Developing strict criteria and gaining experience enhanced patient outcomes in this complex ECLS initiative.
Area of Science:
- Critical Care Medicine
- Cardiopulmonary Support
- Medical Technology
Background:
- Severe acute respiratory distress syndrome (ARDS) carries a high mortality rate.
- Regionalization of extracorporeal life support (ECLS) to high-volume centers is recommended.
- Mobile ECLS teams can rescue patients with severe respiratory disease.
Purpose of the Study:
- To evaluate the effectiveness of a mobile ECLS program for severe ARDS patients.
- To assess patient survival rates associated with mobile ECLS transport.
- To analyze the impact of program experience and criteria adherence on outcomes.
Main Methods:
- Retrospective study of patients receiving ECLS via a mobile program from January 2015 to December 2015.
- Inclusion of patients with severe ARDS requiring ECLS transport due to hemodynamic instability.
- Data collection on patient consultations, ECLS initiation, transport status, and survival.
Main Results:
- 36 patients received ECLS; 21 required mobile ECLS with a 67% survival rate.
- Patient survival significantly increased with program experience (p=0.006).
- Stricter adherence to exclusion criteria correlated with improved survival.
Conclusions:
- Establishing a mobile ECLS program requires extensive planning and infrastructure development.
- Developing clear ECLS implementation criteria optimizes resource use.
- Mobile ECLS programs can improve survival for critically ill patients requiring inter-facility transfer.
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