Interprofessional two-man team approach for interhospital transport of ARDS-patients under extracorporeal membrane oxygenation: a 10 years retrospective observational cohort study.
BACKGROUND
Extra Corporeal Membrane Oxygenation (ECMO) has become an accepted treatment option for severely ill patients. Due to a limited availability of ECMO support therapy, patients must often be transported to a specialised centre before or after cannulation. According to the ELSO guidelines, an ECMO specialist should be present for such interventions. Here we describe the safety and efficacy of a reduced team approach involving one anaesthesiologist, experienced in specialised intensive care medicine, and a specialised critical care nurse.


METHODS
This study is a 10 years retrospective, single institution analysis of all data collected between January 2007 and December 2016 from the medical records at the University Hospital Bonn, Germany.


RESULTS
The Bonner mobile ECMO team was deployed in 170 cases for on-site evaluation for ECMO support therapy. 4 (2.4%) patients died prior to arrival or during the implementation of ECMO support. Of the remaining 166 patients, 126 were cannulated at the referring site, 40 were transported without ECMO. Of those, 21 were subsequently cannulated out our centre. 19 patients never received ECMO treatment. The primary indication for ECMO treatment was ARDS (159/166 patients). Veno-venous ECMO was initiated in 137, whilst 10 patients received veno-arterial ECMO treatment. Mean transportation time was 75 ± 36 min, and mean transport distance was 56 ± 57 km. In total, 26 complications were observed, three being directly transport-related. The overall survival was 55%.


CONCLUSIONS
Initiation of extracorporeal membrane oxygenation and subsequent transport can be safely and efficiently performed by a two-man team with good outcome.
['Ehrentraut|Stefan Felix|SF|', 'Schroll|Barbara|B|', 'Lenkeit|Stefan|S|', 'Ehrentraut|Heidi|H|', 'Bode|Christian|C|', 'Kreyer|Stefan|S|', 'Kögl|Florian|F|', 'Lehmann|Felix|F|', 'Muders|Thomas|T|', 'Scholz|Martin|M|', 'Strater|Claudia|C|', 'Steinhagen|Folkert|F|', 'Theuerkauf|Nils Ulrich|NU|', 'Weißbrich|Carsten|C|', 'Putensen|Christian|C|', 'Schewe|Jens-Christian|JC|0000-0002-6408-0607']
D000293:Adolescent D000328:Adult D000368:Aged D000072080:Anesthesiologists D015331:Cohort Studies D015199:Extracorporeal Membrane Oxygenation D005260:Female D005858:Germany D006785:Hospitals, University D006801:Humans D008297:Male D008875:Middle Aged D009741:Nursing Staff, Hospital D010348:Patient Care Team D010360:Patient Transfer D012128:Respiratory Distress Syndrome D012189:Retrospective Studies D055815:Young Adult
ECMO ARDS Interfacility transport Transport efficiency Transport safety