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Research Article
Primary transport on extracorporeal membrane oxygenation: Two Indian center experience
1 Department of Cardiac Anesthesiology & Critical Care and ECMO Services, Medica Superspecialty Hospital, Kolkata, India
2 Department of Cardiac Anesthesiology & Critical Care and ECMO Services, Medica Superspecialty Hospital, Kolkata, India
3 Department of Cardiac Anesthesiology & Critical Care and ECMO Services, Medica Superspecialty Hospital, Kolkata, India
4 Department of Cardiac Anesthesiology & Critical Care and ECMO Services, Medica Superspecialty Hospital, Kolkata, India
5 Department of Cardiac Anesthesiology & Critical Care and ECMO Services, Ridhivinayak Critical Care & Cardiac Center (RVCC), Mumbai, India
Address correspondence to:
Sandip Gupta
(ECMO Fellow, ESOI), MD (PEDIATRICS), Department of Cardiac Anesthesiology & Critical Care and ECMO Services, Medica Superspecialty Hospital, Kolkata,
India
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Article ID: 100021A05SG2021
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How to cite this article
Gupta S, Chakraborty A, Sarkar K, Chatterjee D, Oza P. Primary transport on extracorporeal membrane oxygenation: Two Indian center experience. Edorium J Anesth 2021;7:100021A05SG2021.ABSTRACT
Aims: Extracorporeal membrane oxygenation (ECMO) can be a lifesaving modality for patients with severe reversible pulmonary and/or cardiac failure, but its use remains restricted to a few highly equipped referral centers. Conventional transports to an ECMO center can be hazardous. Transport teams are usually trained to transfer stable patients across hospitals. As ECMO patients are extremely sick, specially trained critical care teams to deal with all possible complications in these critically ill patients will be required. Therefore, many ECMO centers have developed transport programs with the mobile ECMO team. In this study, we aim to present a brief account of the two-center experience of ECMO transport from India.
Methods: Retrospective observational study is depicting the data of two mobile ECMO teams over 4 years, where 21 patients (16–74 years) were evaluated. Analysis was done for the transport arrangements, different characteristics of ECMO retrieval patients, their outcomes, and predictors of mortality of a total of 21 patients from two different referral centers of India. As it is a retrospective observational study, hence institutional ethical committee approval was waived off.
Results: The mean distance of travel was 87.24±104.5 km (range 2–250 km) and transportation was by road in all cases. About 38% (n=8/21), patients had suffered from complications during transport like hypotension, cardiac arrest. There were no deaths in connection with transportation. The overall mortality rate was 33.3% with no difference over gender, age, duration of pre-ECMO ventilation, or duration of transport. The most common indication associated with ECMO transport was H1N1 infection.
Conclusion: We found that patient transfer if done with proper protocols by a prepared team with full knowledge of problem areas to a referral institution while on ECMO support seems to be safe and adds no significant risk of mortality to ECMO patients.
Keywords: Acute respiratory failure, Extracorporeal membrane oxygenation, Mobile ECMO team, Retrieval, Transport
SUPPORTING INFORMATION
Author Contributions
Sandip Gupta - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Arpan Chakraborty - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kunal Sarkar - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Dipanjan Chatterjee - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Pranay Oza - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Sandip Gupta et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
