Mobile Extracorporeal Membrane Oxygenation for Covid-19 Does Not Pose Extra Risk to Transport Team

• Type of Material: Article
• Authors: Jeffrey Javidfar, Emory University; Ahmed Labib, Hamad General Hospital; Gabrielle Ragazzo, Hamad General Hospital; Ethan Kurtzman, Hartford Hospital; Maria Callahan, Emory University; Silver Heinsar, University of Queensland; Vadim Gudzenko, University of California Los Angeles; Peter Barrett, Piedmont Hospital; Jose Binongo, Emory University; Jane Wenjing Wei, University of Florida; John Fraser, University of Queensland; Jacky Y. Suen, University of Queensland; Gianluigi Li Bassi, University of Queensland; Giles Peek, University of Florida
• Language: English
• Date: 2021-11-22
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © ASAIO 2021
• Final Published Version (URL): http://dx.doi.org/10.1097/MAT.0000000000001602
• Title of Journal or Parent Work: ASAIO JOURNAL
• Volume: 68
• Issue: 2
• Start Page: 163
• End Page: 167
• Grant/Funding Information: The work for this study was supported by internal department funds.
• Keywords: extracorporeal membrane oxygenation; coronavirus disease 2019; extracorporeal membrane oxygenation transport
• Research Categories: Health Sciences, Health Care Management; Biology, Virology

Abstract

Previous experience has shown that transporting patients on extracorporeal membrane oxygenation (ECMO) is a safe and effective mode of transferring critically ill patients requiring maximum mechanical ventilator support to a quaternary care center. The coronavirus disease 2019 (COVID-19) pandemic posed new challenges. This is a multicenter, retrospective study of 113 patients with confirmed severe acute respiratory syndrome coronavirus 2, cannulated at an outside hospital and transported on ECMO to an ECMO center. This was performed by a multidisciplinary mobile ECMO team consisting of physicians for cannulation, critical care nurses, and an ECMO specialist or perfusionist, along with a driver or pilot. Teams practised strict airborne contact precautions with eyewear while caring for the patient and were in standard Personal Protective Equipment. The primary mode of transportation was ground. Ten patients were transported by air. The average distance traveled was 40 miles (SD ±56). The average duration of transport was 133 minutes (SD ±92). When stratified by mode of transport, the average distance traveled for ground transports was 36 miles (SD ±52) and duration was 136 minutes (SD ±93). For air, the average distance traveled was 66 miles (SD ±82) and duration was 104 minutes (SD ±70). There were no instances of transport-related adverse events including pump failures, cannulation complications at outside hospital, or accidental decannulations or dislodgements in transit. There were no instances of the transport team members contracting COVID-19 infection within 21 days after transport. By adhering to best practices and ACE precautions, patients with COVID-19 can be safely cannulated at an outside hospital and transported to a quaternary care center without increased risk to the transport team.