移動中的救護(hù)車.ppt

1、ECMO Transport,ECMO Transport,Intra-hospital ECMO transport Inter-hospital ECMO transport,Intra-hospital ECMO Transport,ECMO set-up site ICU OR Catheterization room ES Ward anywhere,All you need to set up ECMO Put everything on the wheel Then, OR, ICU, cath room, ES, ward, etc,ECMO cart,System sympl

2、ification,Inter-hospital ECMO Transport,2005 Jan. ELSO registry ECMO center in the world,移動中的救護(hù)車,空間狹小 比較: 加護(hù)病房標(biāo)準(zhǔn)床位 20m2 溫度 (不足) 防止散熱的措施 阻礙診斷及治療 移動 (震動, 加速度),移動中的救護(hù)車,不適於診斷及治療病人,運(yùn)送前準(zhǔn)備所需的監(jiān)測多於 運(yùn)送時所需的監(jiān)測,例如 運(yùn)送前測C.O., 但運(yùn)送中不測,Catecholamine,Pump infusion inotropes must use infusion pump pump to pump at most

3、2 kinds (if many, simplify),出發(fā)前最後的準(zhǔn)備,Simplifying treatment: 例如 multiple catecholamine infusion low dose dopamine NTG infusion Sedative drug infusion etc Drain tube Prevent heat loss Ambulance: fuel oxygen infusion drug Patients data,Inter-hospital ECMO transport,Personnel: usually 3 persons CVS surg

4、eon ECMO technician Fellow, resident,Taipei city/Taipei county area = 12,Inter-hospital ECMO Transport,1998 Jan 2004 Jul 31 adult cardiac ECMO inter-hospital transport Distance: 3 300 Km (median: 200 Km) Outcome Wean-off: 11 Bridge to VAD: 8 Bridge to HTx: 1 Die on ECMO: 11 (poor neurological status:7, MOF:4) Cf: in-hospital adult cardiac ECMO (excluding ECPR) at NTUH survival rate: 32.8%, n=64 CF: ELSO registry: adult cardiac ECMO survival rate:33%, n=474,64.5%, 10(32.1%) survival to discharge,Comparison between the survivors a