Transport interhospitalier sous extracorporeal life support : résultats et perspectives après cinq ans d’expérience

Abstract

ObjectiveDescribing the experience of a referral center for interhospital patients transport treated with extracorporeal circulatory or respiratory support (ECLS), the difficulties encountered and the results obtained. Study designRetrospective and observational study. Patients and methodsAll patients with respiratory or circulatory failure accepted for extracorporeal assistance for which routine medical transport was life threatening. Statistical analysisA descriptive analysis was performed (median and interquartile deviation). Comparison of biological data was performed using a non-parametric Wilcoxon test and 5 years overall survival was determined by a Kaplan–Meier analysis. ResultsOver a 55-month period, 29 patients were selected for transportation under ECMO or ECLS. Indication was respiratory failure in 38 % of cases, hemodynamic instability in 52 % of cases and combined symptoms in 10 % of cases. Average duration of transportation was 40km (9–64km). No complication related to transport was observed. Incidence of intrahospital death was 57 %. There was no correlation between death and indication of ECLS. Five-year survival was 55 % and 39 % for venovenous and arteriovenous ECLS, respectively. ConclusionIn our experience, interhospital transport of patients under ECMO is feasible in satisfactory conditions of safety with trained team and standard procedures.