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Adverse Events during Inter-Hospital Transports on Extracorporeal Membrane Oxygenation

机译：体外膜氧合的医院间运输中的不良事件

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Background: Extracorporeal membrane oxygenation (ECMO) may be a lifesaving rescue therapy in refractory, severe respiratory, and/or circulatory failure. To provide the best cost efficiency to the population served and patient outcome, ECMO therapy should be provided by specialized high volume ECMO centers. This requires dedicated transport teams to organize and perform these complex transports. Concerning adverse events and complications during these transfers, only a minimal amount of data has been published. Methods: To shed light on this matter, all medical transport records from transports on ECMO between January 2010 and June 2016 were analyzed. The data was classified in constituent groups and categorized to risk groups. Results: During the study period, 536 transports on ECMO were performed. The transport records could be identified in 514 of these cases (95.9%). In 163 (31.7%) transports 206 adverse events occurred. In 34 transports two or more adverse events passed on the same trip. No deaths occurred during transport. Sixty-five percent (134) of the complications were Patient related; the most prominent was loss of tidal volume with or without fluid flooding of the lung (n = 57, 43%). Lack of control of equipment was the most common Staff related flaw. Causes due to Equipment/technical (n = 30) could be traced to 14.6% of the events. Vehicle/transportation related complications were reported from 26 transfers, a sub-group in which 50% of the reports concerned malfunction of Ambulance utility/electrical, or Wrong ambulance size at hospital or airport. Conclusions: If transporting on ECMO high-risk or sudden threat-of-life situations are inevitable and have to be dealt with immediately, sometimes within seconds. A well-trained staff and an experienced high-volume organization are recommended. Key words: extra corporeal membrane oxygenation; ECMO, transport; adverse event; complication
机译：背景：体外膜氧合（ECMO）可以是难治性，严重呼吸和/或循环衰竭的救命救援治疗。为了为人口提供最佳的成本效率和患者结果，ECMO疗法应由专业的大批量ECMO中心提供。这需要专门的传输团队组织和执行这些复杂的运输。关于这些转移期间的不良事件和并发症，只发布了最小数量的数据。方法：对此问题的阐明，分析了2010年1月至2016年6月在2016年1月至2016年6月之间运输的所有医疗运输记录。数据在成分组中分类，并分类为风险群体。结果：在研究期间，进行了536次ECMO运输。可以在这些病例的514中确定运输记录（95.9％）。 163（31.7％）运输206个不良事件发生。在34中，运送两次或更多的不良事件通过同一行程。运输过程中没有发生死亡。患者有关的并发症六十五（134）个并发症;最突出的是潮气体积丧失或没有肺部流失（n = 57,43％）。缺乏对设备的控制是最常见的相关缺陷。由于设备/技术（n = 30）的原因可以追溯到事件的14.6％。从26个转移报告了车辆/运输相关的并发症，其中一个子集团，其中50％的报告有关救护车效用/电气，或医院或机场错误的救护车大小的故障。结论：如果对ECMO的运输高风险或突发的生活威胁情况是不可避免的，有时在几秒钟内立即处理。建议培训良好的员工和经验丰富的大批量组织。关键词：额外的额外的物质膜氧合; Ecmo，运输;不良事件;并发症

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