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Invasive Kreislaufunterstützungssysteme bei intra- und interhospitalen Transporten

Invasive circulation assist devices for intrahospital and interhospital transport

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Zusammenfassung

Linksventrikuläre Unterstützungssysteme kommen aktuell immer häufiger zum Einsatz. Die Weiterentwicklung der Geräte mit inzwischen perkutaner Implantationsmöglichkeit und einfacherer Handhabung ermöglichen auch ohne herzchirurgischen Operationssaal eine Versorgung mit einem Unterstützungssystem. Dadurch ist es jetzt möglich, auch in kleineren Krankenhäusern ohne entsprechende Abteilung diese Systeme zur Anwendung zu bringen. Aus diesen Gründen werden in letzter Zeit auch immer häufiger Transporte von Patienten an Unterstützungssystemen aus kleineren Kliniken in spezialisierte Zentren durchgeführt. Dieser Übersichtsartikel soll die aktuell vorhandene Erfahrung mit den verschiedenen Systemen beim Patiententransport beleuchten.

Abstract

The use of left ventricular assist devices is becoming increasingly more common. Current developments allow percutaneous canulation without the setting of a cardiac surgery department or a perfusionist. This brings assist device treatment also to smaller facilities and makes the transfer of unstable patients from the primary clinic to specialized centers for extended treatment possible. This review describes the different systems and current experience in patient transfer.

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Literatur

  1. Arlt M, Philipp A, Voelkel S et al (2011) Hand-held minimised extracorporeal membrane oxygenation: a new bridge to recovery in patients with out-of-centre cardiogenic shock. Eur J Cardiothorac Surg 40:689–694

    PubMed  Google Scholar 

  2. Arlt M, Philipp A, Voelkel S et al (2011) Out-of-hospital extracorporeal life support for cardiac arrest-A case report. Resuscitation 82:1243–1245

    Article  PubMed  CAS  Google Scholar 

  3. Brierley J, Carcillo JA, Choong K et al (2009) Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med 37:666–688

    Article  PubMed  Google Scholar 

  4. Burkhoff D, Cohen H, Brunckhorst C et al (2006) A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock. Am Heart J 152:469 e461–e468

    Article  PubMed  Google Scholar 

  5. Cheng JM, Den Uil CA, Hoeks SE et al (2009) Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials. Eur Heart J 30:2102–2108

    Article  PubMed  Google Scholar 

  6. Ciapetti M, Cianchi G, Zagli G et al (2011) Feasibility of inter-hospital transportation using extra-corporeal membrane oxygenation (ECMO) support of patients affected by severe swine-flu(H1N1)-related ARDS. Scand J Trauma Resusc Emerg Med 19:32

    Article  PubMed  Google Scholar 

  7. Clement KC, Fiser RT, Fiser WP et al (2010) Single-institution experience with interhospital extracorporeal membrane oxygenation transport: A descriptive study. Pediatr Crit Care Med 11:509–513

    PubMed  Google Scholar 

  8. Combes A, Leprince P, Luyt CE et al (2008) Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med 36:1404–1411

    Article  PubMed  Google Scholar 

  9. Coppola CP, Tyree M, Larry K et al (2008) A 22-year experience in global transport extracorporeal membrane oxygenation. J Pediatr Surg 3:46–52, discussion 52

    Article  Google Scholar 

  10. Dellinger RP, Vincent JL, Marshall J et al (2008) Important issues in the design and reporting of clinical trials in severe sepsis and acute lung injury. J Crit Care 23:493–499

    Article  PubMed  Google Scholar 

  11. Engstrom AE, Cocchieri R, Driessen AH et al (2011) The Impella 2.5 and 5.0 devices for ST-elevation myocardial infarction patients presenting with severe and profound cardiogenic shock: the Academic Medical Center intensive care unit experience. Crit Care Med 39:2072–2079

    Article  PubMed  Google Scholar 

  12. Forrest P, Ratchford J, Burns B et al (2011) Retrieval of critically ill adults using extracorporeal membrane oxygenation: an Australian experience. Intensive Care Med 37:824–830

    Article  PubMed  CAS  Google Scholar 

  13. Ganslmeier P, Philipp A, Rupprecht L et al (2011) Percutaneous cannulation for extracorporeal life support. Thorac Cardiovasc Surg 59:103–107

    Article  PubMed  CAS  Google Scholar 

  14. Griffith KE, Jenkins E (2010) Abiomed Impella(®) 2.5 patient transport: lessons learned. Perfusion 25:381–386

    Article  PubMed  Google Scholar 

  15. Guirgis M, Kumar K, Zieroth S et al (2010) Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support. Can J Cardiol 26:320–322

    Article  PubMed  Google Scholar 

  16. Haneya A, Philipp A, Foltan M et al (2009) Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution. Ann Saudi Med 29:110–114

    Article  PubMed  Google Scholar 

  17. Lamarche Y, Cheung A, Ignaszewski A et al (2011) Comparative outcomes in cardiogenic shock patients managed with Impella microaxial pump or extracorporeal life support. J Thorac Cardiovasc Surg 142:60–65

    Article  PubMed  Google Scholar 

  18. Maunz O, Horisberger J, Von Segesser L (2008) Bridge to life: the Lifebridge B2T extracorporeal life support system in an in vitro trial. Perfusion 23:279–282

    Article  PubMed  CAS  Google Scholar 

  19. Peek GJ, Mugford M, Tiruvoipati R et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374:1351–1363

    Article  PubMed  Google Scholar 

  20. Perez A, Butt WW, Millar KJ et al (2008) Long-distance transport of critically ill children on extracorporeal life support in Australia. Crit Care Resusc 10:34

    PubMed  Google Scholar 

  21. Philipp A, Arlt M, Amann M et al (2011) First experience with the ultra compact mobile extracorporeal membrane oxygenation system Cardiohelp in interhospital transport. Interact Cardiovasc Thorac Surg

  22. Phillips SJ, Ballentine B, Slonine D et al (1983) Percutaneous initiation of cardiopulmonary bypass. Ann Thorac Surg 36:223–225

    Article  PubMed  CAS  Google Scholar 

  23. Prodhan P, Fiser RT, Cenac S et al (2010) Intrahospital transport of children on extracorporeal membrane oxygenation: indications, process, interventions, and effectiveness. Pediatr Crit Care Med 11:227–233

    Article  PubMed  Google Scholar 

  24. Seyfarth M, Sibbing D, Bauer I et al (2008) A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J Am Coll Cardiol 52:1584–1588

    Article  PubMed  Google Scholar 

  25. Staley LL, Dobberpuhl J, Pierce CN et al (2010) Bridge to decision: SWAT team approach used by Mayo Clinic Arizona’s cardiac transport team. Prog Transplant 20:118–124

    PubMed  Google Scholar 

  26. Thiele H, Lauer B, Hambrecht R et al (2001) Reversal of cardiogenic shock by percutaneous left atrial-to-femoral arterial bypass assistance. Circulation 104:2917–2922

    Article  PubMed  CAS  Google Scholar 

  27. Thiele H, Sick P, Boudriot E et al (2005) Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock. Eur Heart J 26:1276–1283

    Article  PubMed  Google Scholar 

  28. Thiele H, Smalling RW, Schuler GC (2007) Percutaneous left ventricular assist devices in acute myocardial infarction complicated by cardiogenic shock. Eur Heart J 28:2057–2063

    Article  PubMed  Google Scholar 

  29. Wagner K, Sangolt GK, Risnes I et al (2008) Transportation of critically ill patients on extracorporeal membrane oxygenation. Perfusion 23:101–106

    Article  PubMed  CAS  Google Scholar 

  30. Werdan K, Ruß M, Buerke M et al (2011) Deutsch-österreichische S3-Leitlinie Infarktbedingter kardiogener Schock. Diagnose, Monitoring und Therapie. Kardiologe 5:166–224

    Article  Google Scholar 

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Interessenskonflikt

Der korrespondierende Autor weist auf folgende Berziehungen hin:

G.F.: keine.

H.T.: Vortragshonorare und Wissenschaftsunterstützung Maquet Cardiovascular, Hirrlingen, Deutschland; Wissenschaftsunterstützung, Teleflex Medical, USA

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Authors and Affiliations

  1. Klinik für Innere Medizin/Kardiologie, Universität Leipzig; Herzzentrum, Strümpellstraße 39, 04289 , Leipzig, Deutschland

    G. Fürnau &  H. Thiele

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  1. G. Fürnau
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  2. H. Thiele
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Correspondence to G. Fürnau or H. Thiele.

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Fürnau, G., Thiele, H. Invasive Kreislaufunterstützungssysteme bei intra- und interhospitalen Transporten. Notfall Rettungsmed 14, 630–634 (2011). https://doi.org/10.1007/s10049-011-1417-0

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