Practical Considerations for and Outcomes of Interfacility ECMO Transfer of Patients With COVID-19 During a Pandemic: Mayo Clinic Experience

Sen, Ayan; Blakeman, Stephanie; DeValeria, Patrick A.; Peworski, Dominique; Lanza, Louis A.; Downey, Francis X; Alwardt, Cory M.; Dobberpuhl, Jeffrey G.; DeMarco, Matthew; Callisen, Hannelisa; Shively, Jennifer; McKay, Kelly; Singbartl, Kai; Sell-Dottin, Kristen; D’Cunha, Jonathan; Patel, B. M.

doi:10.1016/j.mayocpiqo.2021.02.004

Cited by 6 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior planning, effective communication, checklists, policies, training, and education are key elements to ensure staff safety and sustain the service. [24][25][26][27] In a recent Italian report of VV-ECMO cannulation and interhospital transfer of 36 COVID-19-positive cases, none of the HCWs reported COVID-19 infection. However, the authors did not explain how this was investigated.…”

Section: Resultsmentioning

confidence: 99%

“…Prior planning, effective communication, checklists, policies, training, and education are key elements to ensure staff safety and sustain the service. 24 , 25 , 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

“… 29 However, much of these limitations have been addressed in another study pertaining to the transportation of only five COVID‐19 ECMO patients over a median distance of about 30 km. 27 There appears to have been a focus on education, processes, and proper PPE compliance, and as a result, none of the ECMO team members were known to have been contaminated with COVID‐19. That report did not specify what, if any, testing measures were put in place for the ECMO team members, so some may have been contaminated and remained asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Risk of COVID‐19 infection among mobile extracorporeal membrane oxygenation team

Tawel

Altawil

Koya

et al. 2022

Health Science Reports

View full text Add to dashboard Cite

Background and Aim The transport of coronavirus‐2019 (COVID‐19) patients on extracorporeal membrane oxygenation (ECMO) is a challenging situation, especially for healthcare workers (HCWs), due to the risk of cross‐infection. Hence, certain precautions are needed for their safety. The study aims to evaluate the risk of COVID‐19 transmission to HCWs who transport COVID‐19 patients on ECMO device. Methods A retrospective review of adult patients with COVID‐19 infection supported with ECMO and transported by ground route to the Medical Intensive Care Unit (MICU) at Hamad General Hospital (HGH) and a survey of HCWs involved in those cases. Results A total of 63 HCWs of the mobile ECMO team were exposed to COVID‐19‐positive patients on 199 occasions. HCWs exposure time was nearly 110 h, and the total transport distance was 1018 km. During the study period, only two of the mobile ECMO HCWs tested positive for COVID‐19. There was zero incidence of transfer‐associated injuries or accidents to HCWs. Conclusions The risk of COVID‐19 cross‐infection to the mobile ECMO team seems to be very low, provided that strict infection prevention and control measures are applied.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Prior planning, effective communication, checklists, policies, training, and education are key elements to ensure staff safety and sustain the service. 24 , 25 , 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of COVID‐19 infection among mobile extracorporeal membrane oxygenation team

Tawel

Altawil

Koya

et al. 2022

Health Science Reports

View full text Add to dashboard Cite

show abstract

“…Due to the difficulties reported in embarkation and disembarkation, amplified with the use of ECMO, the limitation of space in air and land ambulances and the dynamics of patient movement, it is pointed out that the risk of adverse events is increased in the operation of this type of transport. Series of cases from the Mayo Clinic, in the United States, pointed out that, during embarkation and disembarkation of five critical patients using ECMO, both in the aircraft and in ground support ambulances, professionals faced several factors such as limited spaces, the need for continuous care, communication problems, high number of equipment that required an electrical grid and high consumption of portable oxygen (18) .…”

Section: Discussionmentioning

confidence: 99%

Aeromedical interhospital transport of an adult with COVID-19 on extracorporeal membrane oxygenation: case report

Carvalho

Silva

Ferreira

et al. 2022

Rev. esc. enferm. USP

View full text Add to dashboard Cite

Objective: To describe the experience of aeromedical interhospital transport of an adult patient with severe hypoxemic respiratory failure due to SARS-CoV-2, on extracorporeal membrane oxygenation. Method: This is a case report, guided by the tool Case Report Guidelines, with a descriptive approach. Data were collected from the digital medical record and field notes after the approval by the Institution and the Human Research Ethics Committee. Results: The transport of a critically ill, unstable patient with acute respiratory syndrome 2 on extracorporeal oxygenation was an opportunity for the team to acquire new knowledge. The proper preparation of the fixed-wing aircraft and the profile of the team of specialist nurses contributed to the safety and quality in the three phases of flight: preflight, in-flight and post-flight. Conclusion: Air transport of adults on cardiopulmonary bypass to referral centers, under the care of an experienced multidisciplinary team, can contribute to positive results. The nurses’ autonomy, their leadership role and expertise in process management are highlighted. Thus, success was evidenced with the patient’s discharge after 45 days from the Intensive Care Unit.

show abstract

“…8 International reports of interhospital transport-of patients with COVID-19 on ECMO via various means of transport have been documented. [9][10][11][12][13][14][15] On evaluating the incidence of major inter-transport complications in patients on ECMO for COVID-19 and non-COVID-19 disease, no significant differences were found. 10 Our urban, academic medical center serves as a busy ECMO referral center within the Southeastern United States with an average of 160 cannulations annually.…”

Section: Introductionmentioning

confidence: 98%

“Pushing Geographic Boundaries: Interfacility transport and remote extracorporeal membrane oxygenation cannulation of patients during COVID-19 pandemic”

et al. 2022

View full text Add to dashboard Cite

Amidst the pandemic, geographical boundaries presented challenges to those in need of higher levels of care from referral centers. Authors sought to evaluate potential predictors of treatment success; assess our transport and remote cannulation process; and identify transport associated complications. Retrospective series of critically ill adults with COVID-19 transferred by our Extracorporeal Membrane Oxygenation (ECMO) team 24 March 2020 through 8 June 2021. Descriptive statistics and associated interquartile ranges (IQR) were used to summarize the data. Sixty-three patients with COVID associated acute respiratory distress syndrome (ARDS) requiring ECMO support were admitted to our ECMO center. Mean age was 44 years old (SD 12; IQR 36–56). 59% ( n = 37) of patients were male. Average body mass index was 39.7 (SD 11.3; IQR 31–48.5). Majority of patients (77.8%; n = 35) had severe ARDS. Predictors of treatment success were not observed. Transport distances ranged from 2.2 to 236 miles (median 22.5 miles; IQR 8.3–79); round trip times from 18 to 476 min (median 83 min; IQR 44–194) . No transport associated complications occurred. Median duration of ECMO support was 17 days (IQR 9.5–34.5). Length of stay in the Intensive Care Unit (median 36 days; IQR 17–49) and hospital (median 39 days; IQR 25–57) varied. Amongst those discharged, 60% survived.

show abstract

Practical Considerations for and Outcomes of Interfacility ECMO Transfer of Patients With COVID-19 During a Pandemic: Mayo Clinic Experience

Cited by 6 publications

References 12 publications

Risk of COVID‐19 infection among mobile extracorporeal membrane oxygenation team

Risk of COVID‐19 infection among mobile extracorporeal membrane oxygenation team

Aeromedical interhospital transport of an adult with COVID-19 on extracorporeal membrane oxygenation: case report

“Pushing Geographic Boundaries: Interfacility transport and remote extracorporeal membrane oxygenation cannulation of patients during COVID-19 pandemic”

Contact Info

Product

Resources

About