title: [Interhospital transfer of ECMO-assisted patients in Martinique].
abstract: OBJECTIVE
  The transportation of critically ill patients in the French West Indies represents a real challenge; in order to ensure territorial continuity of health care provision, the cardiac surgical department of the Fort-de-France Hospital created a mobile ECMO/ECLS unit. The aim of our work is to describe the logistical, technical and financial aspects of the interhospital transfer of ECMO/ECLS-assisted patients in the French Caribbean.
  
  
  METHODS
  All ECMO/ECLS-assisted patients in the French Antilles-Guyane area subsequently repatriated towards the Fort-de-France Hospital were included from December 29th, 2009 to September 30th, 2011. Indication and type of the extracorporeal assistance used, location of departure, type of transport vehicle, complications during transfer, survival after hospital discharge and direct costs were collected.
  
  
  RESULTS
  Nineteen patients were supported by our mobile unit far away from our centre (sex-ratio 0.63, median age 34years old [16-64]). Twelve were assisted by ECMO for a refractory ARDS, and seven were assisted by ECLS for a refractory cardiogenic shock. Four patients were transferred by ambulance (7-29km), seven by helicopter (190-440km), and eight by plane (440-1430km). No patient died during transfer. No major adverse event occurred during these transfers. Fifteen patients survived. An economic assessment was conducted.
  
  
  CONCLUSIONS
  Interhospital transfer of ECMO/ECLS-assisted patients by land or air is technically feasible under perfectly secure conditions in our area. Prior coordination of this activity has helped to make it affordable.
authors: Samu-Smur 972, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, Fort-de-France cedex, Martinique.
authors: D
authors: D
authors: Roger
authors: J-M
authors: JM
authors: Dudouit
authors: D
authors: D
authors: Résière
authors: H
authors: H
authors: Mehdaoui
authors: D
authors: D
authors: Courcier
authors: L
authors: L
authors: Villain
authors: C
authors: C
authors: Léonard
authors: F
authors: F
authors: Roques
authors: G
authors: G
authors: Lebreton
mesh_terms: D000328:Adult; D000401:Aircraft / Q000191:economics; D000552:Ambulances / Q000191:economics; D016507:Cardiology Service, Hospital / Q000458:organization & administration; D002391:Catchment Area, Health; D003365:Costs and Cost Analysis; D004389:Durable Medical Equipment / Q000191:economics / Q000706:statistics & numerical data; D006804:Ergonomics; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation; D005260:Female; D005616:French Guiana; D019430:Guadeloupe; D015386:Hazardous Substances; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration; D006801:Humans; D008297:Male; D008395:Martinique; D008875:Middle Aged; D008952:Mobile Health Units / Q000191:economics; D010360:Patient Transfer / Q000191:economics / Q000458:organization & administration*; D013503:Surgery Department, Hospital / Q000458:organization & administration; D014187:Transportation of Patients / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D014894:Weights and Measures; D014900:West Indies
chemical_list: D015386:Hazardous Substances