Korean J Thorac Cardiovasc Surg.  2017 Oct;50(5):363-370. 10.5090/kjtcs.2017.50.5.363.

Inter-Facility Transport on Extracorporeal Life Support: Clinical Outcomes and Comparative Analysis with In-house Patients

• Hong TH
• Lee H
• Jung JJ
• Cho YH
• Sung K
• Yang JH
• Lee YT
• Cho SH

• KMID: 2398392
• DOI: http://doi.org/10.5090/kjtcs.2017.50.5.363

Abstract

BACKGROUND
Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure, and the demand for inter-facility transportation on ECLS is expanding. However, little is known about post-transportation outcomes, the clinical safety of such transportation, or the characteristics of the transported patients.
METHODS
This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transport, as well as a comparative analysis of clinical outcomes with those of in-house patients. We also analyzed the risk factors for hospital mortality in the entire ECLS population using univariate and multivariate analyses to investigate the effects of transport.
RESULTS
All 44 patients were safely transported without adverse events. The average travel distance was 178.7 km, with an average travel time of 74.0 minutes. Early survival of the transported group seemed to be better than that of the in-house group, but the difference was not statistically significant (70.5% vs. 56.6%, p=0.096). The incidence of complications was similar between the 2 groups, except for critical limb ischemia, which was significantly more common in the transported group than in the in-house group (25.0% vs. 8.1%, p=0.017). After adjusting for confounders, being part of the transported group was not a predictor of early death (adjusted odds ratio, 0.689; p=0.397).
CONCLUSION
Transportation of patients on ECLS is relatively safe, and the clinical outcomes of transported patients are comparable to those of in-house ECLS patients. Although matched studies are required, our study demonstrates that transporting patients on ECLS did not increase their risk of hospital mortality after adjustment for other factors.

Keyword

Extracorporeal membrane oxygenation; Transport

MeSH Terms

Extracorporeal Membrane Oxygenation
Extremities
Heart
Hospital Mortality
Humans
Incidence
Ischemia
Lung
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk Factors
Transportation
Transportation of Patients