ECMO is in the air: Long distance air/ground transport of a child on extra corporeal membrane oxygenation

ECMO is in the air: Long distance air/ground transport of a child on extra corporeal membrane oxygenation

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Background: Extracorporeal membrane oxygenation (ECMO) is a temporary mechanical support system that handles the function of the heart and/or lungs in patients with a variety of cardiac and respiratory problems.Veno-arterial ECMO is most commonly used for patients recovering from heart surgery, suffering from cardiac shock, or awaiting a heart transplant.Case report: A 7 year old boy with a single ventricle physiology was admitted for a Fontan procedure with repair of the common valve.

At the end of cottonmouth 3.5 high shirt surgery, transesophagal echocardiography showed a severely depressed myocardial function, and weaning of bypass required a high inotropic support.During the following week, the heart never recovered, with an ejection fraction at 24%.Veno-Arterial ECMO was decided on postoperative day 9 with a 19 Fr venous cannula inserted through the right jugular vein into the intracardiac Fontan baffle, and a 15 Fr arterial cannula into the right carotid artery.

On ECMO 173rd airborne brigade patch day 7, after failure to wean from ECMO, he was listed for an urgent heart transplant, with the suggestion of a transfer to Europe, for a shorter transplantation delay.The ECMO team from Hamad Hospital in Qatar accomplished the transfer successfully, on a humanitarian basis.The transfer was done on ECMO Day 10.

The child was safely admitted to a hospital in Belgium, and listed again for an urgent heart transplant.Conclusion: With an experienced team, and the proper equipment, on-ECMO air transport of critical patients over thousands of kilometers is today safely feasible.Keywords: ECMO, Medical air transport, Critical care, Levosimendan.