One-Year Experience With a Mobile Extracorporeal Life Support Service

Penn Lung Rescue

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Severe acute respiratory distress syndrome is associated with a high mortality rate. The International Extracorporeal Membrane Oxygenation Network recommends regionalization of extracorporeal life support (ECLS) to high-volume centers and development of mobile ECLS teams to rescue patients with severe acute respiratory disease. Methods A tertiary medical center developed a mobile team and the infrastructure to support a ECLS transport service available 24 hours a day, 7 days a week. We conducted a retrospective study of all consecutive patients presenting for ECLS for severe acute respiratory distress syndrome from outside hospitals through our mobile ECLS program associated with hemodynamic instability from January 1, 2015, until December 31, 2015. Results During the study period, 106 consultations for ECLS were received, and 36 patients were placed on ECLS. Of these 36 ECLS patients, 11 were deemed stable enough for transport before ECLS, and 21 required mobile ECLS by the mobile ECLS, with a survival of 67% (14 of 21). The other 4 ECLS patients were inhouse patients and therefore received ECLS in a nonmobile fashion. In addition, 28 patients were transferred to our hospital who did not receive ECLS. Patient survival increased significantly with increased experience with the program, as the highest mortality rates were early in the program (p = 0.006), and in conjunction with stricter adherence to our exclusion criteria. Conclusions The formation of a mobile ECLS program is a complex undertaking that took 2 years of planning to develop. Development of criteria for ECLS implementation can guide appropriate resources utilization and may prevent their use in patients with little to no chance of survival.

Original languageEnglish (US)
Pages (from-to)1509-1515
Number of pages7
JournalAnnals of Thoracic Surgery
Volume104
Issue number5
DOIs
StatePublished - Nov 1 2017

Fingerprint

Extracorporeal Membrane Oxygenation
Severe Acute Respiratory Syndrome
Adult Respiratory Distress Syndrome
Survival
Mortality
Acute Disease

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

One-Year Experience With a Mobile Extracorporeal Life Support Service. / Penn Lung Rescue.

In: Annals of Thoracic Surgery, Vol. 104, No. 5, 01.11.2017, p. 1509-1515.

Research output: Contribution to journalArticle

Penn Lung Rescue. / One-Year Experience With a Mobile Extracorporeal Life Support Service. In: Annals of Thoracic Surgery. 2017 ; Vol. 104, No. 5. pp. 1509-1515.
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abstract = "Background Severe acute respiratory distress syndrome is associated with a high mortality rate. The International Extracorporeal Membrane Oxygenation Network recommends regionalization of extracorporeal life support (ECLS) to high-volume centers and development of mobile ECLS teams to rescue patients with severe acute respiratory disease. Methods A tertiary medical center developed a mobile team and the infrastructure to support a ECLS transport service available 24 hours a day, 7 days a week. We conducted a retrospective study of all consecutive patients presenting for ECLS for severe acute respiratory distress syndrome from outside hospitals through our mobile ECLS program associated with hemodynamic instability from January 1, 2015, until December 31, 2015. Results During the study period, 106 consultations for ECLS were received, and 36 patients were placed on ECLS. Of these 36 ECLS patients, 11 were deemed stable enough for transport before ECLS, and 21 required mobile ECLS by the mobile ECLS, with a survival of 67{\%} (14 of 21). The other 4 ECLS patients were inhouse patients and therefore received ECLS in a nonmobile fashion. In addition, 28 patients were transferred to our hospital who did not receive ECLS. Patient survival increased significantly with increased experience with the program, as the highest mortality rates were early in the program (p = 0.006), and in conjunction with stricter adherence to our exclusion criteria. Conclusions The formation of a mobile ECLS program is a complex undertaking that took 2 years of planning to develop. Development of criteria for ECLS implementation can guide appropriate resources utilization and may prevent their use in patients with little to no chance of survival.",
author = "{Penn Lung Rescue} and William Vernick and Miano, {Todd A.} and Jacob Gutsche and William Vernick and Miano, {Todd A.} and Mark Mikkelsen and Harish Ramakrishna and Harish Ramakrishna and Pavan Atluri and Prashanth Vallabhajosyula and Christian Bermudez and Augoustides, {John G.} and Prakash Patel and Matt Williams and John Haddle and Jeremy Cannon and Jesse Raiten and Meghan Lane-Fall and Jacob Gutsche and Wilson Szeto",
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T1 - One-Year Experience With a Mobile Extracorporeal Life Support Service

AU - Penn Lung Rescue

AU - Vernick, William

AU - Miano, Todd A.

AU - Gutsche, Jacob

AU - Vernick, William

AU - Miano, Todd A.

AU - Mikkelsen, Mark

AU - Ramakrishna, Harish

AU - Ramakrishna, Harish

AU - Atluri, Pavan

AU - Vallabhajosyula, Prashanth

AU - Bermudez, Christian

AU - Augoustides, John G.

AU - Patel, Prakash

AU - Williams, Matt

AU - Haddle, John

AU - Cannon, Jeremy

AU - Raiten, Jesse

AU - Lane-Fall, Meghan

AU - Gutsche, Jacob

AU - Szeto, Wilson

PY - 2017/11/1

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N2 - Background Severe acute respiratory distress syndrome is associated with a high mortality rate. The International Extracorporeal Membrane Oxygenation Network recommends regionalization of extracorporeal life support (ECLS) to high-volume centers and development of mobile ECLS teams to rescue patients with severe acute respiratory disease. Methods A tertiary medical center developed a mobile team and the infrastructure to support a ECLS transport service available 24 hours a day, 7 days a week. We conducted a retrospective study of all consecutive patients presenting for ECLS for severe acute respiratory distress syndrome from outside hospitals through our mobile ECLS program associated with hemodynamic instability from January 1, 2015, until December 31, 2015. Results During the study period, 106 consultations for ECLS were received, and 36 patients were placed on ECLS. Of these 36 ECLS patients, 11 were deemed stable enough for transport before ECLS, and 21 required mobile ECLS by the mobile ECLS, with a survival of 67% (14 of 21). The other 4 ECLS patients were inhouse patients and therefore received ECLS in a nonmobile fashion. In addition, 28 patients were transferred to our hospital who did not receive ECLS. Patient survival increased significantly with increased experience with the program, as the highest mortality rates were early in the program (p = 0.006), and in conjunction with stricter adherence to our exclusion criteria. Conclusions The formation of a mobile ECLS program is a complex undertaking that took 2 years of planning to develop. Development of criteria for ECLS implementation can guide appropriate resources utilization and may prevent their use in patients with little to no chance of survival.

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