固定翼飞机转运体外膜氧合患者经验总结

Summary of experience in transporting patients with extracorporeal membrane oxygenation by fixed-wing aircraft

目的总结体外膜氧合(ECMO)危重症患者固定翼飞机转运经验。方法回顾性收集并分析我国2017年5月至2023年3月北京市红十字会999专业航空医疗救援联合相关医疗单位采用固定翼飞机转运的11名ECMO支持患者信息,总结ECMO患者固定翼飞机转运中的注意事项以及可能发生的不良事件。结果男性9名,女性2名,平均年龄(56.6±16.6)岁;10例患者诊断重症肺炎,1例患者诊断心肌病合并心源性休克;静脉-静脉ECMO 10例,静脉-动脉ECMO 1例;2例(18%)患者采用B-1999固定翼飞机转运,9例(82%)采用B-5999固定翼飞机转运,飞行距离(713.9±388.6)km,飞行时间(1.5±0.7)h,转运总时间(4.4±0.8)h;转运医护团队包括4人(医生2名,护士2名)。所有患者均成功转运,其中两名患者在转运途中出现不良反应(心率下降、飞行中氧分压降低)。结论在专业、经验丰富的ECMO医护团队和设备准备充分的情况下,固定翼飞机空中医疗救援ECMO患者安全可行。

Objective To summarize the experience of fixed-wing aircraft transport for critically ill patients supported by extracorporeal membrane oxygenation(ECMO).Methods Data of 11 ECMO-supported patients transported by fixed-wing aircraft from May 2017 to March 2023 by the Beijing Red Cross 999 Aero-Medical Rescue Team in collaboration with relevant medical units were retrospectively collected and analyzed.The precautions and potential adverse events during fixed-wing aircraft transport of ECMO patients were summarized.Results Of the 11 patients,9 were male and 2 were female,with an average age of(56.6±16.6)years.Ten patients were diagnosed with severe pneumonia,and one patient was diagnosed with cardiomyopathy complicated by cardiogenic shock.Ten patients received veno-venous(V-V)ECMO,and one patient received veno-arterial(V-A)ECMO.Two patients(18%)were transported by B-1999 fixed-wing aircraft,while nine patients(82%)were transported by B-5999 fixed-wing aircraft,with a flight distance of(713.9±388.6)km,flight time of(1.5±0.7)h,and total transport time of(4.4±0.8)h.The transport medical team consisted of four members(two doctors and two nurses).All patients were successfully transported,with two patients experiencing adverse reactions during transport,including decreased heart rate and decreased partial pressure of oxygen during flight.Conclusion Fixed-wing aircraft aerial medical rescue for ECMO patients is safe and feasible with a professional and experienced ECMO medical team and adequate equipment preparation.