ECMO is in the air: Long distance air/ground transport of a child on extra corporeal membrane oxygenation

IF 0.3 Q4 CRITICAL CARE MEDICINE Egyptian Journal of Critical Care Medicine Pub Date : 2018-12-01 DOI:10.1016/j.ejccm.2018.12.010
Jana Assy , Ibrahim Fawzi , Mariam Arabi , Ziad Bulbul , Fadi Bitar , Mariane Majdalani , Rana Sharara , Issam El Rassi
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引用次数: 1

Abstract

Background

Extracorporeal membrane oxygenation (ECMO) is a temporary mechanical support system that handles the function of the heart and/or lungs in patients with a variety of cardiac and respiratory problems. Veno-arterial ECMO is most commonly used for patients recovering from heart surgery, suffering from cardiac shock, or awaiting a heart transplant.

Case report

A 7 year old boy with a single ventricle physiology was admitted for a Fontan procedure with repair of the common valve. At the end of surgery, transesophagal echocardiography showed a severely depressed myocardial function, and weaning of bypass required a high inotropic support. During the following week, the heart never recovered, with an ejection fraction at 24%. Veno-Arterial ECMO was decided on postoperative day 9 with a 19 Fr venous cannula inserted through the right jugular vein into the intracardiac Fontan baffle, and a 15 Fr arterial cannula into the right carotid artery.

On ECMO day 7, after failure to wean from ECMO, he was listed for an urgent heart transplant, with the suggestion of a transfer to Europe, for a shorter transplantation delay.

The ECMO team from Hamad Hospital in Qatar accomplished the transfer successfully, on a humanitarian basis. The transfer was done on ECMO Day 10. The child was safely admitted to a hospital in Belgium, and listed again for an urgent heart transplant.

Conclusion

With an experienced team, and the proper equipment, on-ECMO air transport of critical patients over thousands of kilometers is today safely feasible.

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体外膜氧合:在体外膜氧合下对儿童进行长距离空中/地面输送
体外膜氧合(ECMO)是一种临时的机械支持系统,用于处理各种心脏和呼吸系统疾病患者的心脏和/或肺功能。静脉-动脉ECMO最常用于心脏手术恢复期、心脏休克或等待心脏移植的患者。病例报告:一名7岁 的单心室男孩接受了修复总瓣膜的Fontan手术。在手术结束时,经食管超声心动图显示心肌功能严重下降,切断旁路需要高强度的肌力支持。在接下来的一周内,心脏再也没有恢复,射血分数为24%。静脉-动脉ECMO于术后第9天决定,通过右颈静脉插入19 Fr静脉插管至心内Fontan挡板,并将15 Fr动脉插管至右颈动脉。在ECMO第7天,在未能脱离ECMO后,他被列为紧急心脏移植,并建议转移到欧洲,以缩短移植延迟。卡塔尔哈马德医院体外膜肺小组在人道主义基础上成功完成了转移。移植于ECMO第10天完成。这个孩子被安全送往比利时的一家医院,并再次被列为紧急心脏移植手术。结论有了经验丰富的团队和适当的设备,危重患者的体外膜肺氧合空运数千公里是安全可行的。
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来源期刊
自引率
0.00%
发文量
5
审稿时长
42 weeks
期刊介绍: The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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