A Review of 100 Patients Transported on Extracorporeal Life Support

• Published in: ASAIO journal (1992) Vol. 48; no. 6; pp. 612 - 619
• Main Authors: Foley, David S, Pranikoff, Thomas, Younger, John G, Swaniker, Fresca, Hemmila, Mark R, Remenapp, Robert A, Copenhaver, William, Landis, Denise, Hirschl, Ronald B, Bartlett, Robert H
• Format: Journal Article
• Language: English
• Published: United States Copyright by the American Society for Artificial Internal Organs 01-11-2002
• Subjects: Adult; Air Ambulances; Ambulances; Child; Child, Preschool; Emergency Medical Services - methods; Extracorporeal Membrane Oxygenation - mortality; Heart Failure - mortality; Heart Failure - therapy; Humans; Infant, Newborn; Middle Aged; Midwestern United States; Respiration, Artificial; Respiratory Insufficiency - mortality; Respiratory Insufficiency - therapy; Survival Rate; Transportation of Patients - methods; Midwestern United States
• ISSN: 1058-2916; 1538-943X
• DOI: 10.1097/00002480-200211000-00007

Between May 1990 and January 1999, 100 patients (68 adult, 32 pediatric) with severe respiratory or cardiac instability were successfully transported to the University of Michigan Medical Center on extracorporeal life support. Diagnoses included adult respiratory distress syndrome (n = 78), cardiac failure (n = 7), sepsis (n = 7), asthma (n = 5), respiratory distress syndrome (of newborn) (n = 2), and airway compromise (n = 1). Of the patients, 53 were supported with venovenous bypass and 47 with venoarterial bypass. Patients were transported by ground ambulance (n = 80), helicopter (n = 15), or fixed-wing aircraft (n = 5). The median transport distance was 44 miles (range 2–790 miles), and the median transport time was 5 hours and 30 minutes (range1 h 33 min to 16 h 6 min). Sixty-six patients (66%) survived to discharge. One death occurred during cannulation, and two patients died before cannulation began. Complications that occurred during transport included 10 cases of electrical failure, 3 cases of circuit tubing leakage, and 1 case each of circuit rupture, membrane lung thrombosis, and membrane lung leakage. None of the complications occurring during transport had an adverse effect on outcome. We conclude that the long distance transport of patients on extracorporeal life support can be safely accomplished and is an effective option for the unstable patient with severe respiratory or cardiac failure.