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Interhospital Aircraft/Ground Extracorporeal Membrane Oxygenation Transportation by a Mobile Extracorporeal Membrane
Tanıl Kendirli1, Fevzi Kahveci1, Serhan Özcan1
1Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey.
Insights
Mobile extracorporeal membrane oxygenation teams safely transported pediatric patients with acute cardiogenic shock via aircraft and ground vehicles. This critical care transport bridges patients to survival or long-term circulatory support, demonstrating the effectiveness of specialized mobile teams.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular surgery
- Transport medicine
Background:
- Extracorporeal membrane oxygenation (ECMO) is vital for pediatric circulatory and respiratory failure.
- Timely transport to ECMO centers is crucial for acute cardiogenic shock patients.
- Limited data exists on pediatric ECMO transport via aircraft and ground vehicles.
Purpose of the Study:
- To describe features of children transported via ECMO by air/ground.
- To highlight the importance of extracorporeal cardiopulmonary resuscitation in pediatric transport.
- To evaluate the safety and efficacy of mobile ECMO transport teams.
Main Methods:
- Retrospective case series of 6 pediatric patients with acute cardiogenic shock.
- Transport via fixed-wing or commercial aircraft and ground ambulances.
- Data collected on patient demographics, diagnosis, transport details, and outcomes.
Main Results:
- Six pediatric patients (median age 112 months) received venoarterial ECMO support during transport.
- Transport distances averaged 618 km via aircraft or ground vehicles.
- No adverse events occurred during transport, with successful bridging to further care.
Conclusions:
- Mobile pediatric ECMO transport teams ensure safe air and ground transportation for high-risk children.
- This service is critical for patients with acute cardiogenic shock requiring ECMO.
- Successful transport facilitates bridging to survival or long-term circulatory support.
Objective:
Extracorporeal membrane oxygenation is a life-saving treatment for patients with circulatory and respiratory failure refractory to standard therapy. However, safe and timely patient transport to the referral extracorporeal membrane oxygenation center is critical for better patient outcomes in patients with acute cardiogenic shock. This study aimed to describe children's features who were transferred to our center under extracorporeal membrane oxygenation by aircraft/ground vehicle and demonstrated the importance of extracorporeal cardiopulmonary resuscitation for transported children.
Materials And Methods:
We report the first Turkish pediatric case series of patients with acute cardiogenic shock transported by aircraft and ground ambulances on extracorporeal membrane oxygenation support to a referral extracorporeal membrane oxygenation center between January 2016 and January 2021.
Results:
Overall, 6 patients on venoarterial extracorporeal membrane oxygenation support were transported by aircraft and ground vehicles to our pediatric intensive care unit. Transport was achieved by fixed-wing aircraft in 5 patients and commercial aircraft in 1. Our mobile extracorporeal membrane oxygenation team cannulated 3 patients, and 3 patients were cannulated by the team at the hospital they applied to. The median age was 112 (range: 14-204) months and the median weight was 28.6 kg (range: 8.6-57.2 kg). The etiology of acute cardiogenic shock was fulminant myocarditis in 4 patients, dilated cardiomyopathy in 1, and transposition of great arteries and atrial flutter in 1. The median distance of travel for the patients to our hospital was 618 (407-955) km. No adverse events were detected during aircraft or ground vehicle transport.
Conclusion:
Mobile pediatric extracorporeal membrane oxygenation transport teams may provide safe aircraft and ground vehicle transportation in high-risk patients with acute cardiogenic shock bridging to survival or long-term circulatory support.
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