Out-of-center extracorporeal membrane oxygenation for adult cardiogenic shock patients.
Patients with cardiogenic shock refractory to conventional management require advanced mechanical circulatory support such as extracorporeal membrane oxygenation (ECMO). In hospitals lacking ECMO facilities, interhospital transportation is necessary for further patient management. Thirty-one adult cardiac patients, who were transported to our hospital by our ECMO transport team between January 1998 and July 2004, were enrolled in this study. The median transportation distance was 200 km (range: 3-300 km). During transportation, the ECMO circuit per se and the patients did not have complications. Of the 31 patients, 20 (64.2%) were weaned off ECMO or bridged to ventricular assist devices and 10 patients (32.1%) survived to discharge. Delayed transfer (>2 days) and high organ dysfunction score were associated with poor outcomes. The survival rate was similar to that of our in-hospital group (survival rate: 32.8%, n = 64). In conclusion, adult cardiogenic shock patients requiring interhospital ECMO transport had a reasonable chance of survival.
Huang
Shu-Chien
SC
Department of Surgery and Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Chen
Yih-Sharng
YS
Chi
Nai-Hsin
NH
Hsu
Jiun
J
Wang
Chih-Hsien
CH
Yu
Hsi-Yu
HY
Chou
Nai-Kuan
NK
Ko
Wen-Je
WJ
Wang
Shoei-Shen
SS
Lin
Fang-Yue
FY
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000628:therapy*; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014187:Transportation of Patients; D016896:Treatment Outcome