First experiences with a new miniaturised life support system for mobile percutaneous cardiopulmonary bypass☆

Summary 

Aim

As a result of healthcare changes, interhospital transfer has become common in the care even of patients with severely deteriorated cardiopulmonary function. This study describes experience with the use of a specially downsized, lightweight extracorporeal circulation system (Emergency-MECC) which enables percutaneous cardiopulmonary bypass support in resistant cases of severe cardiac and cardiopulmonary failure.

Methods

Between March 2006 and June 2007, the Emergency-MECC system, consisting of a centrifugal pump and a membrane oxygenator, was used to facilitate interhospital transfer of five adults. The technique included percutaneous cannulation, femoro-femoral venoarterial (n=4) and femoro-jugular venovenous (n=1) life support by extracorporeal membrane oxygenation.

Results

Bedside cannulation was uneventful and the extracorporeal circulation support achieved adequate systemic blood flow and oxygen delivery in all cases. Vasopressor support could be immediately reduced and hypoxaemia was treated effectively. During interhospital transfer (air ambulance in three and ground ambulance in two cases), no technical complication occurred. Hospital survival rate was 80%.

Conclusions

The Emergency-MECC system is safe, rapid and highly effective in restoring blood flow and oxygen delivery. Interhospital transfer on cardiopulmonary bypass was made possible without extended technical or personnel support.

Keywords: Emergency medical service, Cardiogenic shock, Extracorporeal membrane oxygenation, Cardiopulmonary bypass, Emergency-MECC