弥合差距:专家主导的ECMO检索的安全性和结果
Mircea R Mihu1,2, Marc O Maybauer3,4,5, Kaitlyn Cain1
1Specialty Critical Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK, United States.
Frontiers in medicine
|September 8, 2023
概括
强化主导的体外膜氧化 (ECMO) 程序可以安全地执行远程导管和检索. 这种方法解决了心胸外科医生的短缺问题,改善了患者获得关键护理的机会.
科学领域:
- 心血管医学 心血管医学
- 关键护理医学 关键护理医学
- 手术创新 在外科创新.
背景情况:
- 体外膜氧化 (ECMO) 炮管通常由心胸外科医生 (CTS) 进行.
- 越来越多的ECMO利用使得CTS可用于远程道的可用性受到压力.
- 在ECMO需求和外科医生远程检索的可用性之间存在差距.
研究的目的:
- 评估一个由专家主导的远程ECMO导管和检索程序的安全性和有效性.
- 评估与强度医师执行的ECMO相关的并发症和结果.
- 为了应对心胸外科医生有限的可用性所带来的可访问性挑战.
主要方法:
- 从2014年10月到2022年9月进行的前性,单中心的观察性研究.
- 包括需要ECMO管道治疗的患者在转诊设施进行运输.
- 收集有关管类型,运输方法,并发症和结果的数据.
主要成果:
- 303名患者在5个州的47家转诊医院接受了ECMO管治疗.
- 静脉动脉ECMO在61%的患者中使用,静脉动脉在38%的患者中使用,静脉动脉在1%的患者中使用.
- 所有被运送的患者都安全抵达,没有任何重大途径并发症,无论运输方式 (救护车,直升机,飞机).
结论:
- 专家主导的ECMO程序可以成功执行远程导管和检索.
- 非心胸外科医生可以在ECMO手术中实现较低的并发症率.
- 这种模式扩大了获得关键ECMO支持的机会,缓解了外科医生短缺.
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