Abstract 21: Mobile Extracorporeal Life Support for Patients With Refractory Cardiogenic Shock or Reanimation - The Concept of a Regional Supply Network
Objectives: To prove the concept of a regional supply network for mobile extracorporeal life support (ECLS), provided by an university heart centre, specialised on mechanical support.
Methods: We established a mobile ECLS service for regional catheter laboratories (cath-lab). We included patients with severe refractory cardiogenic shock and/or resuscitation if locally available therapies failed and a safe transport to a heart centre was not possible. Without immediate mechanical support the patients are considered to die. Logistic optimization was achieved by 1) use of a miniaturized ECLS device (Life Box, Sorin), which is 24-hours instantly ready for use, 2) provision of a passenger car with flash lights for going, 3) placement of stickers with the 24 hours emergency numbers on prominent places, 4) training of cardiologists in insertion of femoral ECLS cannulae.
Results: Seven cath-labs joined the supply network. From 08/2011 until 05/2012 mobile ECLS was used in 39 cases (age: 3 to 86 years; mean 58). Distance: 0.5 to 224 km. Resuscitation time: 5 -240 min. All patients received on-site femoral veno-arterial ECLS. Duration of support: 1 to 28 days (mean:8.3). Further treatment include: implantation of a ventricular assist device, cardiac transplantation, coronary artery bypass grafting, left ventricular thrombectomie, PTCA, mitral- and aortic valve replacement. 30-day survival without significant neurological deficits was 44% for men, 50% for women.
Conclusion: Mobile ECLS therapy, using recent technology, offers new options for patients, who are otherwise likely to die. The concept of a regional ECLS supply network ensures an optimized logistic and minimization of loss of time
- © 2012 by American Heart Association, Inc.