ECMO快速反应团队的建立和管理实践

Extracorporeal membrane oxygenation rapid response team building and management practice

目的总结体外膜肺氧合(ECMO)快速反应团队的建立和管理经验,探索更加高效的抢救工作模式。方法选择2015年1月至2020年9月青岛大学附属医院收治的85例行ECMO治疗的患者为研究对象。以2015年1月至2019年12月应用常规ECMO治疗的38例患者作为对照组;以2020年1月至9月成立体外生命支持快速反应团队后采用ECMO治疗的47例患者作为试验组。比较两组团队准备时间、置管时间、救治成功率、并发症发生率和设备故障次数的差异。结果两组患者在性别、年龄、疾病种类方面比较差异均无统计学意义。试验组团队准备时间、置管时间均较对照组明显缩短〔团队准备时间(min):31.79±6.10比67.16±30.49,置管时间(min):40.62±7.13比84.89±19.29〕,并发症发生率较对照组明显降低〔4.3%(2/47)比21.1%(8/38)〕,差异均有统计学意义(均P<0.05)。结论 ECMO快速反应团队能够缩短抢救准备时间,降低并发症的发生,提高团队救治效率,为应对急危重患者的抢救提供思路。

Objective To summarize the establishment and management experience of extracorporeal membrane oxygenation(ECMO)rapid response team,and explore a more efficient rescue mode.Methods From January 2015 to September 2020,85 patients treated with ECMO in Affiliated Hospital of Qingdao University were selected as the research objects.Thirty-eight patients treated with conventional ECMO from January 2015 to December 2019 were selected as the control group,and 47 patients treated with ECMO rapid response team from January 2020 to September 2020 were selected as the experimental group.The differences in team preparation time,catheterization time,treatment success rate,incidence of complications and equipment failure frequency between the two groups were compared.Results There were no significant differences in gender,age or disease types between the two groups.The team preparation time and catheterization time of the experimental group were significantly shorter than those of the control group[team preparation time(minutes):31.79±6.10 vs.67.16±30.49,catheterization time(minutes):40.62±7.13 vs.84.89±19.29],and the incidence of complications was significantly lower than that of the control group[4.3%(2/47)vs.21.1%(8/38)],and the differences were statistically significant(all P<0.05).Conclusion ECMO rapid response team can shorten the rescue preparation time,reduce the occurrence of complications,improve the team treatment efficiency,and provide ideas for emergency and critical patients.