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首页> 外文期刊>Artificial Organs >BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program
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BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program

机译：最佳生活 - “为生命带来ECMO仿真” - 以及医学模拟改进了一个区域ECMO计划

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Abstract The implemented “ECMO for Greater Poland” program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region. The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF), and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication. Finally, it promotes donation after circulatory death (DCD) strategy in selected organ donor cases. ECMO enables recovery of organs’ function after unsuccessful lifesaving treatment. Because this organizational model is complex and expensive, we use advanced high‐fidelity medical simulation to prepare for real‐life implementation. During the first four months, we performed scenarios mimicking “ECMO for DCD,” “ECMO for ECPR (extended cardiopulmonary resuscitation),” “ECMO for RRF” and “ECMO in hypothermia.” It helped to create algorithms for aforementioned program arms. In the following months, three ECMO courses for five departments in Poznan (capitol city of Greater Poland) were organized and standardized operating procedures for road ECMO transportation within Medical Emergency System were created. Soon after simulation program, 38 procedures with ECMO perfusion therapy including five road transportations on ECMO were performed. The Maastricht category II DCD procedures were done four times on real patients and in two cases double successful kidney transplantations were carried out for the first time in Poland. ECMO was applied in two patients with hypothermia, nine adult patients with heart failure, and five with RRF, for the first time in the region. In the pediatric group, ECMO was applied in four patients with RRF and 14 with heart failure after cardiac surgery procedures. Additionally, one child was treated successfully following 200 km‐long road transport on ECMO. We achieved good and promising results especially in VV ECMO therapy. Simulation‐based training enabled us to build a successful procedural chain, and to eliminate errors at the stage of identification, notification, transportation, and providing ECMO perfusion therapy. We discovered the important role of medical simulation, not only to test the medical professional’s skills, but also to promote ECMO therapy in patients with critical/life‐threatening states. Moreover, it also resulted in increase of the potential organ pool from DCD in the Greater Poland region.
机译：摘要采用已实施的“大波兰的ECMO”计划充分利用了ECMO（体外膜氧合）灌注疗法，促进该地区350万居民的卫生。实施的主要受试者是体温过低的患者，具有严重的可逆呼吸衰竭（RRF），以及治疗其他关键状态，导致心力衰竭，如突发的心脏骤停，心肌休克或急性中毒。最后，促进循环死亡（DCD）策略在选定的器官供体案件中促进捐赠。 ECMO能够在不成功的救生处理后恢复器官的功能。由于这种组织模型复杂且昂贵，我们使用先进的高保真医学模拟来准备现实生活实现。在前四个月，我们对模仿“ECMO的DCD”的情景，“ECMO为ECPR（扩展了心肺复苏），”RRF的Ecmo“和”体温过低“。它有助于为上述程序武器创建算法。在接下来的几个月里，在波兹南的五个部门（大哥国会大厦）的三个ECMO课程被组织，并创建了医疗紧急系统内的道路ECMO运输的标准化操作程序。在仿真程序之后不久，38项采用ECMO灌注治疗的程序，包括ECMO上的五次道路运输。 Maastricht II类DCD程序在真正的患者中进行了四次，并且在两种情况下，在波兰首次进行双重成功的肾移植。 ECMO应用于两名体温过低，9名成年患者的心力衰竭患者，以及该地区的第一次与RRF有5名。在儿科小组中，在心脏手术手术后的心力衰竭后，在4例RRF和14患者中应用ECMO。此外，在ECMO上遵循200公里漫长的公路运输，将一个孩子成功处理。我们在VV Ecmo疗法中取得了良好和有前途的结果。基于模拟的培训使我们能够建立一个成功的程序链，并在识别，通知，运输和提供ECMO灌注治疗的阶段消除错误。我们发现了医疗模拟的重要作用，不仅要测试医疗专业人员的技能，还要促进危及危险/危及危及危险性国家的Ecmo治疗。此外，还导致从大波兰地区的DCD增加潜在器官池。

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