摘要
目的总结体外生命支持团队院际转运体外膜氧合(ECMO)支持下的危重患者的经验。方法回顾性分析2017年12月至2019年12月华中阜外医院体外生命支持团队院际转运的ECMO支持下的86例危重患者的临床资料,转运前制定详尽的转运策略,做好充足的物品准备,并充分准确评估患者的病情和血管条件,转运途中做好仪器和患者的安全管理,制定紧急预案,转运后做好仪器设备的整理和再检查等工作,确保患者的生命体征平稳和设备仪器的安全运行。结果体外生命支持团队到达当地医院,全部86例患者均充分评估后置管,在ECMO辅助下由救护车成功转运至华中阜外医院(区域心血管医学中心)接受进一步治疗。其中清醒ECMO转运36例,气管插管麻醉下ECMO转运50例,转运过程中出现不良事件5例,均为机械或人为故障,无转运途中死亡事件发生。结论通过制定合理的转运流程,强化转运过程中的细节管理,体外循环团队可以安全运行ECMO辅助支持下的危重患者的院际转运。
Objective To summarize the experience of interhospital transport of critically ill patients supported with extracorpo⁃real membrane oxygenation(ECMO)running by the extracorporeal life support team.Methods Clinical data of 86 critically ill pa⁃tients with ECMO support running by the extracorporeal life support team at Huazhong Fuwai Hospital from December 2017 to December 2019 were retrospectively analyzed.A detailed transfer strategy was formulated to ensure that the patient's vital signs were stable and the equipment operated safely(including preparing sufficient items before transfer,fully and accurately assessing the patient's condition and vascular conditions,doing a good job in the safety management of equipment and patients during transfer,formulating emergency plans,arranging and re-examinating equipment after transfer and so on).Results All the 86 patients were intubated at local hospital after fully evaluated by the extracorporeal life support team,and were successfully transferred to Huazhong Fuwai Hospital(regional cardiovascular medical center)by ambulance with the aid of the above transfer method under the assistance of ECMO for further treat⁃ment.Among them,36 cases were awake and 50 cases were anesthetized under tracheal intubation.There were 5 cases of adverse e⁃vents caused by mechanical or human failures,and no death occurred during the transport.Conclusion By formulating a reasonable transfer process and strengthening the detailed management,the extracorporeal life support team can safely finish the inter-hospital transfer of critically ill patients supported by ECMO.
作者
陈月
钱晓亮
李建朝
孟凡伟
张静
郭素萍
叶发民
杨雷一
张加强
程兆云
刘前进
Chen Yue;Qian Xiaoliang;Li Jianchao;Meng Fanwei;Zhang Jing;Guo Suping;Ye Famin;Yang Leiyi;Zhang Jiaqiang;Cheng Zhaoyun;Liu Qianjin(People's Hospital of Henan Province,People's Hospital of Zhengzhou University,Huazhong Fuwai Cardiovascular Disease Hospital,Zhengzhou 450000,China)
出处
《中国体外循环杂志》
2020年第6期333-336,共4页
Chinese Journal of Extracorporeal Circulation
基金
河南省医学科技攻关计划项目(20190796)。
关键词
体外生命支持
体外膜氧合
院际转运
危重症患者
治疗策略
循环衰竭
呼吸衰竭
Cardiopulmonary life support
Extracorporeal membrane oxygenation
Interhospital transfer
Critical patients
Treatment strategy
Circulatory failure
Respiratory failure
