Usefulness of the Yokohama Advanced Cardiopulmonary Help Team in patients with acute respiratory distress syndrome.

Autor: Utada S; Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan., Taniguchi H; Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan., Honzawa H; Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan., Takeda T; Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan., Abe T; Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan., Takeuchi I; Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan.
Jazyk: angličtina
Zdroj: Acute medicine & surgery [Acute Med Surg] 2024 Apr 23; Vol. 11 (1), pp. e953. Date of Electronic Publication: 2024 Apr 23 (Print Publication: 2024).
DOI: 10.1002/ams2.953
Abstrakt: Aim: To evaluate whether establishing an extracorporeal membrane oxygenation (ECMO) specialist team, termed the Yokohama Advanced Cardiopulmonary Help Team (YACHT), affected the outcomes and centralization of patients requiring ECMO in Yokohama-Yokosuka regions.
Methods: This retrospective observational study included patients aged ≥18 years and treated with venovenous-ECMO for severe acute respiratory distress syndrome (ARDS) from 2014 to 2023. The primary outcome was intensive care unit (ICU) mortality. The secondary outcomes included ICU-, mechanical ventilator-, and ECMO-free days and complications during the first 28 days.
Results: This study included 46 (12 without- and 34 with-YACHT) patients. Among with-YACHT patients, 24 were transferred to our hospital from other hospitals, 14 were assessed by dispatched ECMO physicians, and 9 were transferred after ECMO introduction. No without-YACHT patients were transferred from other hospitals. With-YACHT patients experienced coronavirus disease 2019-associated respiratory failure more frequently (0 vs. 27, p  < 0.001) and had higher Acute Physiology and Chronic Health Evaluation II scores (19 vs. 24, p  = 0.037) and lower Respiratory Extracorporeal Membrane Oxygenation Survival Prediction scores (4 vs. 2, p  = 0.021). ICU mortality was not significantly different between the groups (2 vs. 4, p  = 0.67). ICU- (14 vs. 9, p  = 0.10), ventilator- (11 vs. 5, p  = 0.01), and ECMO-free days (20 vs. 14, p  = 0.038) were higher before YACHT establishment. The incidences of complications were not significantly different between the groups.
Conclusions: Mortality was not significantly different pre- and post-YACHT establishment; however, it helped promote regionalization and centralization in Yokohama-Yokosuka areas. We will collect more cases to demonstrate YACHT's usefulness.
Competing Interests: The authors declare no conflicts of interest.
(© 2024 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.)
Databáze: MEDLINE
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