The first experience of long-term interregional transportation of a patient using the venoarterial extracorporeal membrane oxygenation in the Republic of Tatarstan

Abstract

Introduction. Patient transportation on VA ECMO (veno-arterial extracorporeal membrane oxygenation) is poorly described in the international and Russian literature. Mostly, shortdistance (423±89 km) patient transportation due to respiratory failure has been described, with a duration of 175±14 minutes.

Objective. To familiarize the Russian medical community with the first long-distance vehicle transportation of a patient on VA ECMO for cardiac indications in the Republic of Tatarstan, Russian Federation.

Clinical сase. This article describes a clinical case of a 40-year-old patient admitted to the Interregional Clinical and Diagnostic Center in Kazan with critical aortic stenosis and extremely reduced left ventricular contractility (ejection fraction less than 10%). An algorithm for making decisions on patient management tactics during the in-hospital phase is presented, as well as the process of long-term (over 8 hours) interhospital patient transport to the V. I. Shumakov National Medical Research Center of Transplantology and Orthopedics, Ministry of Health of the Russian Federation (Moscow) using exclusively ambulance vehicles.

Discussion. The wider use of mechanical circulatory support devices challenges anesthesiologists and resuscitators regarding interhospital patient transport using this technology. Theoretical training and careful patient monitoring will reduce the likelihood of complications during patient transport using VA ECMO.