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1000 Titel
  • ECLS supported transport of ICU patients: does out-of -house implantation impact survival?
1000 Autor/in
  1. Fleissner, Felix |
  2. Mogaldea, Alexandru |
  3. Martens, Andreas |
  4. Natanov, Ruslan |
  5. Rümke, Stefan |
  6. Salman, Jawad |
  7. Kaufeld, Tim |
  8. Ius, Fabio |
  9. Beckmann, Erik |
  10. Haverich, Axel |
  11. Kühn, Christian |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-06-02
1000 Erschienen in
1000 Quellenangabe
  • 16(1):158
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13019-021-01508-9 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170971/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Extracorporeal life support (ECLS) is an established tool to stabilize severely ill patients with therapy-refractory hemodynamic or respiratory failure. Recently, we established a mobile ECLS retrieval service at our institution. However, data on the outcome of patients receiving ECLS at outside hospitals for transportation into tertiary hospitals is still sparse.!##!Methods!#!We have analyzed all patients receiving ECLS in outside hospitals (Transport group, TG) prior to transportation to our institution and compared the outcome to our in-house ECLS experience (Home Group, HG).!##!Results!#!Between 2012 and 2018, we performed 978 ECLS implantations, 243 of which were performed on-site in tertiary hospitals for ECLS supported transportation. Significantly more veno-venous systems were implanted in TG (n = 129 (53%) vs. n = 327 (45%), p = 0.012). Indication for ECLS support differed between the groups, with more pneumonia; acute respiratory distress syndromes in the TG group and of course, more postcardiotomy patients in HG. Mean age was 47 (± 20) (HG) vs. 48 (± 18) (TG) years, p = 0.477 with no change over time. No differences were seen in ECLS support time (8.03 days ±8.19 days HG vs 7.81 days ±6.71 days TG, p = 0.675). 30-day mortality (n = 379 (52%) (HG) vs. n = 119 (49%) (TG) p = 0.265) and death on ECLS support (n = 322 (44%) (HG) vs. n = 97 (40%) TG, p = 0.162) were comparable between the two groups, despite a more severe SAVE score in the v-a TG (HG: - 1.56 (± 4.73) vs. TG -3.93 (± 4.22) p < 0.001). Mortality rates did not change significantly over the years. Multivariate risk analysis revealed Influenza, Peak Insp. Pressure at implantation, pO2/FiO2 ratio and ECLS Score (SAVE/RESP) as well as ECLS support time to be independent risk factors for mortality.!##!Conclusion!#!Mobile ECLS support is a tremendous challenge. However, it is justified to offer 24 h/7d ECLS standby for secondary and primary hospitals as a tertiary hospital. Increasing indications and total numbers for ECLS support raise the need for further studies to evaluate outcome in these patients.
1000 Sacherschließung
lokal Aged [MeSH]
lokal Hospitals, Community [MeSH]
lokal Risk Factors [MeSH]
lokal Critical Care [MeSH]
lokal Transportation of Patients/statistics
lokal Extracorporeal Membrane Oxygenation/statistics
lokal Male [MeSH]
lokal Secondary Care Centers [MeSH]
lokal ECLS
lokal Tertiary Care Centers/statistics
lokal Research Article
lokal Female [MeSH]
lokal ARDS
lokal Respiratory Insufficiency/therapy [MeSH]
lokal Adult [MeSH]
lokal Pneumonia/therapy [MeSH]
lokal Humans [MeSH]
lokal Cardiogenic shock
lokal Retrospective Studies [MeSH]
lokal Middle Aged [MeSH]
lokal Transport
lokal Transportation of Patients/methods [MeSH]
lokal Survival Rate [MeSH]
lokal Respiratory Insufficiency/physiopathology [MeSH]
lokal Respiratory Distress Syndrome/physiopathology [MeSH]
lokal Hemodynamics [MeSH]
lokal Respiratory Distress Syndrome/therapy [MeSH]
lokal Pneumonia/physiopathology [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-3754-7689|https://frl.publisso.de/adhoc/uri/TW9nYWxkZWEsIEFsZXhhbmRydQ==|https://frl.publisso.de/adhoc/uri/TWFydGVucywgQW5kcmVhcw==|https://frl.publisso.de/adhoc/uri/TmF0YW5vdiwgUnVzbGFu|https://frl.publisso.de/adhoc/uri/UsO8bWtlLCBTdGVmYW4=|https://frl.publisso.de/adhoc/uri/U2FsbWFuLCBKYXdhZA==|https://frl.publisso.de/adhoc/uri/S2F1ZmVsZCwgVGlt|https://frl.publisso.de/adhoc/uri/SXVzLCBGYWJpbw==|https://frl.publisso.de/adhoc/uri/QmVja21hbm4sIEVyaWs=|https://frl.publisso.de/adhoc/uri/SGF2ZXJpY2gsIEF4ZWw=|https://frl.publisso.de/adhoc/uri/S8O8aG4sIENocmlzdGlhbg==
1000 Hinweis
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1000 Erstellt am 2023-11-15T19:13:51.631+0100
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