PMID- 35403027 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220413 IS - 2666-2507 (Electronic) IS - 2666-2507 (Linking) VI - 12 DP - 2022 Apr TI - Implementation and outcomes of an urban mobile adult extracorporeal life support program. PG - 78-92 LID - 10.1016/j.xjtc.2021.12.011 [doi] AB - OBJECTIVE: Although extracorporeal life support (ECLS) has been increasingly adopted as rescue therapy for cardiac and pulmonary failure, it remains limited to specialized centers. The present study reports our institutional experience with mobile ECLS across broad indications, including postcardiotomy syndrome, cardiogenic shock, and COVID-19 acute respiratory failure. METHODS: We performed a retrospective review of all patients transported to our institution through our mobile ECLS program from January 1, 2018, to January 15, 2021. RESULTS: Of 110 patients transported to our institution on ECLS, 65.5% required venovenous, 30.9% peripheral venoarterial, and 3.6% central venoarterial support. The most common indications for mobile ECLS were acute respiratory failure (46.4%), COVID-19-associated respiratory failure (19.1%), cardiogenic shock (18.2%) and postcardiotomy syndrome (11.8%). The median pre-ECLS Pao(2):Fio(2) for venovenous-ECLS was 64 mm Hg (interquartile range [IQR], 53-75 mm Hg) and 95.8 mm Hg (IQR, 55-227 mm Hg) for venoarterial-ECLS, whereas median pH and base deficit were 7.25 (IQR, 7.16-7.33) and 7 mmol/L (IQR, 4-11 mmol/L) for those requiring venoarterial-ECLS. Patients were transported using a ground ambulance from 50 institutions with a median distance of 27.5 miles (IQR, 18.7-48.0 miles). Extracorporeal circulation was established within a median of 45 minutes (IQR, 30-55 minutes) after team arrival. Survival to discharge was 67.3% for those requiring venovenous-ECLS for non-COVID-19 respiratory failure, 52.4% for those with COVID-19%, and 54.1% for those requiring venoarterial-ECLS. CONCLUSIONS: Patients can be safely and expeditiously placed on ECLS across broad indications, utilizing ground transportation in an urban setting. Clinical outcomes are promising and comparable to institutional non-transfers and those reported by Extracorporeal Life Support Organization. CI - (c) 2022 The Author(s). FAU - Hadaya, Joseph AU - Hadaya J AD - Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, Calif. FAU - Sanaiha, Yas AU - Sanaiha Y AD - Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, Calif. FAU - Gudzenko, Vadim AU - Gudzenko V AD - Division of Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, Calif. FAU - Qadir, Nida AU - Qadir N AD - Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, Calif. FAU - Singh, Sumit AU - Singh S AD - Division of Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, Calif. FAU - Nsair, Ali AU - Nsair A AD - Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, Calif. FAU - Cho, Nam Yong AU - Cho NY AD - Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, Calif. FAU - Shemin, Richard J AU - Shemin RJ AD - Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, Calif. FAU - Benharash, Peyman AU - Benharash P AD - Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, Calif. CN - UCLA Extracorporeal Life Support Group LA - eng PT - Journal Article DEP - 20220123 PL - United States TA - JTCVS Tech JT - JTCVS techniques JID - 101768546 PMC - PMC8987336 OTO - NOTNLM OT - COVID-19 OT - ECLS, extracorporeal life support OT - ELSO, Extracorporeal Life Support Organization OT - ICU, intensive care unit OT - VA, venoarterial OT - VIS, Vasoactive Inotrope Score OT - VV, venovenous OT - cardiogenic shock OT - critical care OT - extracorporeal life support OT - extracorporeal membrane oxygenation OT - respiratory failure OT - transport FIR - Anderson, Ida IR - Anderson I FIR - Bland, Stephanie IR - Bland S FIR - Boldt, David IR - Boldt D FIR - Cardiel, Rene IR - Cardiel R FIR - Chen, Wei Ting IR - Chen WT FIR - Chinchilla, Jennie IR - Chinchilla J FIR - Crager, Sara IR - Crager S FIR - De La Cruz, Kim IR - De La Cruz K FIR - Dries, Ryan IR - Dries R FIR - Fries, Jessica IR - Fries J FIR - Meltzer, Joseph IR - Meltzer J FIR - Gates, Jacquelyn IR - Gates J FIR - Hernandez, Christopher IR - Hernandez C FIR - Hernandez-Morgan, Marisa IR - Hernandez-Morgan M FIR - Kratzert, Wolf B IR - Kratzert WB FIR - Kutateladze, Nikoloz IR - Kutateladze N FIR - Lahar, Saba IR - Lahar S FIR - Lim, George IR - Lim G FIR - McNeil, Ann IR - McNeil A FIR - Mears, Katelyn IR - Mears K FIR - Melendez, Ashley IR - Melendez A FIR - Murata, Curtis IR - Murata C FIR - Ortiz, Christopher IR - Ortiz C FIR - Pagel, Anthony IR - Pagel A FIR - Redkar, Prachi IR - Redkar P FIR - Salib, Daniel IR - Salib D FIR - Samson, Jessica IR - Samson J FIR - Satou, Nancy IR - Satou N FIR - Toft, Lisa IR - Toft L FIR - Warren, Savonna IR - Warren S FIR - Wolfe, Michael IR - Wolfe M FIR - Young, Andrew IR - Young A EDAT- 2022/04/12 06:00 MHDA- 2022/04/12 06:01 PMCR- 2022/01/23 CRDT- 2022/04/11 05:33 PHST- 2021/03/27 00:00 [received] PHST- 2021/12/04 00:00 [accepted] PHST- 2022/04/11 05:33 [entrez] PHST- 2022/04/12 06:00 [pubmed] PHST- 2022/04/12 06:01 [medline] PHST- 2022/01/23 00:00 [pmc-release] AID - S2666-2507(22)00024-4 [pii] AID - 10.1016/j.xjtc.2021.12.011 [doi] PST - epublish SO - JTCVS Tech. 2022 Jan 23;12:78-92. doi: 10.1016/j.xjtc.2021.12.011. eCollection 2022 Apr.