Clinical course and long-term outcome following venoarterial extracorporeal life support-facilitated interhospital transfer of patients with circulatory failure.
BACKGROUND
Interhospital transfer of patients experiencing circulatory failure and shock has a significant risk of cardiovascular deterioration and death. Extracorporeal life support (ECLS) is a rescue tool for hemodynamic stabilization that makes patient transportation much safer.


METHODS
Demographic data, clinical course, and outcome data were reviewed for patients who underwent placement of a venoarterial ECLS in a remote hospital and were transported to our tertiary care facility.


RESULTS
68 patients were transported to our center with ECLS. The majority of these patients (79%) underwent cardiopulmonary resuscitation during or immediately prior to ECLS initiation. The mean patient age was 52 years, and 53 patients were male. The most common underlying diagnosis was acute coronary syndrome (60%). Overall, 23 patients underwent consecutive cardiosurgical procedures, including coronary artery bypass grafting in 12, and left ventricular assist device and biventricular assist device implantation in 11. The median duration of ECLS was 5 days. None of the patients died during transportation. Twelve of the surgically treated patients survived, as well as 21 patients with non-surgical treatment, which resulted in an overall survival of 33 patients (48.5%).


CONCLUSION
ECLS-facilitated patient transfer enables safe interhospital transfer of critically ill patients. In this study, a relevant percentage of patients were in need of a cardiosurgical intervention. The long-term survival rate of these patients supports the further use of this time-, cost- and personnel-demanding strategy.
['Schopka|Simon|S|', 'Philipp|Alois|A|', 'Hilker|Michael|M|', 'Müller|Thomas|T|', 'Zimmermann|Markus|M|', 'Arlt|Matthias|M|', 'Rupprecht|Leopold|L|', 'Schmid|Christof|C|', 'Lunz|Dirk|D|']
D054058:Acute Coronary Syndrome D058406:Cardiac Resynchronization Therapy D006348:Cardiac Surgical Procedures D016887:Cardiopulmonary Resuscitation D015199:Extracorporeal Membrane Oxygenation D005260:Female D005858:Germany D006323:Heart Arrest D006439:Hemodynamics D006801:Humans D000069451:Long Term Adverse Effects D008297:Male D008875:Middle Aged D010043:Outcome and Process Assessment, Health Care D012308:Risk Management D012769:Shock D014187:Transportation of Patients
Shock Cardiopulmonary resuscitation Extracorporeal circulation Heart arrest