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A model for delivery of extracorporeal life support in a stand-alone veterans affairs medical center. Artif Organs 2024 Jun;48(6):675-682

Date

02/07/2024

Pubmed ID

38321771

DOI

10.1111/aor.14722

Scopus 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 GH

Authors

G Hossein Almassi MD Professor in the Surgery department at Medical College of Wisconsin
Lucian A. Durham MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Paul L. Linsky MD Associate 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
H Adam Ubert MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Cardiac Surgical Procedures
Extracorporeal Membrane Oxygenation
Female
Hospitals, Veterans
Humans
Male
Middle Aged
Patient Transfer
Respiratory Insufficiency
Retrospective Studies
Shock, Cardiogenic
United States
United States Department of Veterans Affairs