'Extracorporeal Membrane Oxygenation for Greater Poland' Program: How to Save Lives and Develop Organ Donation?
| Autor: | Marcin Zieliński, Bartłomiej Perek, Paweł Sobczyński, Małgorzata Ładzińska, Marek Dąbrowski, Marcin Misterski, Sebastian Stefaniak, M. Kiel, Maciej Sip, Michael Czekajlo, Marek Karczewski, Wojciech Telec, Tomasz Małkiewicz, Wojciech Mrówczyński, Konrad Baumgart, Piotr Ładziński, Aleksander Pawlak, I. Kiel-Puślecka, Marcin Ligowski, Mateusz Puślecki, Tomasz Kłosiewicz, Piotr Buczkowski, Marek Jemielity, Łukasz Gąsiorowski |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 030213 general clinical medicine medicine.medical_specialty Tissue and Organ Procurement medicine.medical_treatment Hypothermia 030204 cardiovascular system & hematology Young Adult 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine medicine Extracorporeal membrane oxygenation Humans Organ donation Cardiopulmonary resuscitation Intensive care medicine Simulation Training Kidney transplantation Aged Transplantation Education Medical business.industry Cardiogenic shock Middle Aged medicine.disease Kidney Transplantation Tissue Donors Death surgical procedures operative Respiratory failure Heart failure Female Surgery Poland medicine.symptom business Algorithms |
| Zdroj: | Transplantation Proceedings. 50:1957-1961 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2018.02.159 |
| Popis: | The "ECMO for Greater Poland" program takes full advantage of the extracorporeal membrane oxygenation (ECMO) perfusion therapy opportunities to promote the health of the 3.5 million inhabitants in the region. The main implementation areas are treatment of patients with hypothermia; severe reversible respiratory failure (RRF); critical states resulting in heart failure, that is, cardiac arrest, cardiogenic shock, or acute intoxication; and promotion of the donor after circulatory death (DCD) strategy in selected organ donor cases, after unsuccessful life-saving treatment, to achieve organ recovery. This organizational model is complex and expensive, so we used advanced high-fidelity medical simulation tests to prepare for real-life experience. Over the course of 4 months we performed scenarios including "ECMO for DCD," "ECMO for extended cardiopulmonary resuscitation," "ECMO for RRF," and "ECMO in hypothermia." Soon after these simulations, Maastricht category II DCD procedures were performed involving real patients and resulting in 2 successful double kidney transplantations for the first time in Poland. One month later we treated 2 hypothermia patients (7 adult patients with heart failure and 5 patients with reversible respiratory failure) with ECMO for the first time in the region. Fortunately, we have discovered an important new role of medical simulation. It can be used not only for skills testing but also as a tool to create non-existing procedures and unavailable algorithms. The result of these program activities will promote the care and treatment of patients in critical condition with ECMO therapy as well as increase the potential organ pool from DCDs in the Greater Poland region of Poland. |
| Databáze: | OpenAIRE |
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