Prone transportation to an ECMO center

Anton Nikouline; Lorenzo Del Sorbo; John T Granton

doi:10.1016/j.tacc.2021.04.003

Prone transportation to an ECMO center

Trends Anaesth Crit Care. 2021 Aug:39:10-11. doi: 10.1016/j.tacc.2021.04.003. Epub 2021 May 3.

Authors

Anton Nikouline¹, Lorenzo Del Sorbo², John T Granton²

Affiliations

¹ Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Canada.
² Interdepartmental Division of Critical Care Medicine, Toronto General Hospital, Toronto, Ontario, Canada.

Abstract

Acute Respiratory Distress Syndrome (ARDS) accounts for 10% of all intensive care unit admissions and mortality remains exceedingly high ranging from 35 to 46%. Prone positioning has demonstrated benefit as a treatment option in the moderate to severe subset of ARDS patients. Referral to an extracorporeal membrane oxygenation (ECMO) center remains the standard of care for patients with refractory hypoxemia. Transfer of these already critically ill patients is high risk but there is a possibility for improved oxygenation on transport with prone positioning. Currently there is limited data on the safe transportation of prone patients to ECMO centers. Herein we describe a case of an ARDS patient safely transported prone with minimal ad hoc adjustments to standard ambulance transport.

Keywords: Critical care; Extracorporeal membrane oxygenation; Prone position; Referral and consultation; Respiratory distress syndrome.