Application of mobile extracorporeal membrane oxygenation in inter-hospital transport of pediatric acute respiratory distress syndrome: Retrospective studies for 7 case / 解放军医学杂志

ABSTRACT

Objective: To investigate the application and safety of mobile extracorporeal membrane oxygenation (ECMO) in inter-hospital transport of pediatric patients with acute respiratory distress syndrome (pARDS). Methods: Data were retrospectively collected of children with pARDS transported by mobile ECMO from Jan. 1, 2019 to Nov. 25, 2019. All children suffered from severe ARDS, and the curative effect in their local hospital was not good, the disease was still progressing after traditional conservative treatments such as mechanical ventilation (MV), small tidal volume protective ventilation, prone position ventilation, and fluid restriction, and the severity of the disease reached the applicable ECMO indications. The age, sex, clinical manifestations, ECMO transfer time, ECMO transfer distance, ECMO duration, MV duration, length of hospital stay, prognosis and complications were collected and analyzed. Results: Seven pediatric patients were included in present study including 6 males and 1 female, aged (43.3±42.9) months, body weight (18.4±17.7) kg, ECMO travel distance (9.4±8.9) km, and ECMO travel time (5.7±17.2) min. After arriving in the Guangdong Provincial People's Hospital, 6 pediatric patients (4 were cured and 2 died) were discharged and 1 pediatric patient was still being treated. The MV duration was (17±11) d, ECMO duration was (307.4±233.6) h, and the length of hospital stay was (23±15) d. Of the 7 pediatric patients, 4 were caused by adenovirus infection, and the other 3 cases were infected by unclear pathogenic bacteria. The cause for death was severe sepsis shock combined with severe heart dysfunction and severe pulmonary hemorrhage. Conclusions: With a skilled ECMO teams, mobile ECMO may provide a safe and effective inter-hospital transport of pARDS patients. Mobile ECMO provides a good way to treat children patients with respiratory critical condition.