A model for delivery of extracorporeal life support in a stand-alone veterans affairs medical center. Artif Organs 2024 Feb 06
Date
02/07/2024Pubmed ID
38321771DOI
10.1111/aor.14722Scopus ID
2-s2.0-85184427783 (requires institutional sign-in at Scopus site)Abstract
INTRODUCTION: For the Veterans Health Administration (VHA) to continue to perform complex cardiothoracic surgery, there must be an established pathway for providing urgent/emergent extracorporeal life support (ECLS). Partnership with a nearby tertiary care center with such expertise may be the most resource-efficient way to provide ECLS services to patients in post-cardiotomy cardiogenic shock or respiratory failure. The goal of this project was to assess the efficiency, safety, and outcomes of surgical patients who required transfer for perioperative ECLS from a single stand-alone Veterans Affairs Medical Center (VAMC) to a separate ECLS center.
METHODS: Cohort consisted of all cardiothoracic surgery patients who experienced cardiogenic shock or refractory respiratory failure at the local VAMC requiring urgent or emergent institution of ECLS between 2019 and 2022. The primary outcomes are the safety and timeliness of transport.
RESULTS: Mean time from the initial shock call to arrival at the ECLS center was 2.8 h. There were no complications during transfer. Six patients (86%) survived to decannulation.
CONCLUSION: These results suggest that complex cardiothoracic surgery can be performed within the VHA system and when there is an indication for ECLS, those services can be safely and effectively provided at an affiliated, properly equipped center.
Author List
Seadler BD, Melamed J, Sow M, Rogers AL, Syed A, Linsky PL, Ubert HA, Schena S, Durham LA, Almassi GHAuthors
G Hossein Almassi MD Professor in the Surgery department at Medical College of WisconsinPaul L. Linsky MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Stefano Schena MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
