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Nater M, Nelson-McMillan K, Elzein C, Boone A, Urbas C. Development of pediatric multidisciplinary extracorporeal membrane oxygenation simulations: A novel educational program to enhance team communication and emergency preparedness. Perfusion 2023; 38:1142-1152. [PMID: 35613946 DOI: 10.1177/02676591221105408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pediatric extracorporeal membrane oxygenation (ECMO) is a high risk, low-volume technology. Infrequency of this technology and associated complications may translate to unfamiliarity of identification and management of potentially life-threatening events, which may require knowledge and procedural skills to be performed quickly. Providers involved in managing ECMO must be able to promptly identify and initiate management for such events, particularly when surgical colleagues are not readily available. METHODS A multidisciplinary ECMO simulation program was implemented in a tertiary children's hospital. Over 18 months, a prospective, observational study was conducted evaluating simulations involving circuit and patient emergencies, teamwork and communication behaviors and technical skills. An on-line survey was sent to participants following sessions to evaluate post-simulation confidence, lessons learned and potential barriers to implementation of necessary skills and behaviors. RESULTS Ten simulation sessions occurred during implementation. Mean participants per session was 7 (range: 5-11). Eight Pediatric Cardiac Intensive Care Unit attendings, four Advance Practice Nurses, 54 pediatric intensive care unit registered nurses, and 55 pediatric respiratory therapists attended. Tasks with highest self-reported increase in confidence were related to (1) diagnosis (tension pneumothorax, oxygenator failure, and ventricular tachycardia), (2) fluid administration and (3) early and efficient mobilization for ECPR, with less reported confidence increase with technical skills More than 90% of participants provided a task or behavior they would implement if a specific emergency was encountered in real-life following simulation training. Real-life application occurred following simulations with participants reporting direct impact of training on their ability to perform the skill efficiently and correctly. CONCLUSIONS Implementation of ECMO multidisciplinary simulations provides structured opportunities for the team to learn and practice ECMO skills together in scenarios they may encounter without surgical presence. Ensuring competency of providers through implementation of such a program may improve patient safety through enhanced team communication, knowledge, and hands-on experience.
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Affiliation(s)
- Melissa Nater
- Advocate Children's Heart Institute, Advocate Children's Hospital, Oak Lawn, IL, USA
| | - Kristen Nelson-McMillan
- Advocate Children's Heart Institute, Advocate Children's Hospital, Oak Lawn, IL, USA
- Department of Pediatrics, Division of Critical Care, University of Chicago, Chicago, IL, USA
| | - Chawki Elzein
- Advocate Children's Heart Institute, Advocate Children's Hospital, Oak Lawn, IL, USA
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Alison Boone
- Advocate Christ Medical Center Simulation Center, Oak Lawn, IL, USA
| | - Cynthia Urbas
- Department of Surgery, Advocate Children's Hospital, Oak Lawn, IL, USA
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Olson T, Anders M, Burgman C, Stephens A, Bastero P. Extracorporeal cardiopulmonary resuscitation in adults and children: A review of literature, published guidelines and pediatric single-center program building experience. Front Med (Lausanne) 2022; 9:935424. [PMID: 36479094 PMCID: PMC9720280 DOI: 10.3389/fmed.2022.935424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/04/2022] [Indexed: 09/19/2023] Open
Abstract
Extracorporeal cardiopulmonary resuscitation (ECPR) is an adjunct supportive therapy to conventional cardiopulmonary resuscitation (CCPR) employing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in the setting of refractory cardiac arrest. Its use has seen a significant increase in the past decade, providing hope for good functional recovery to patients with cardiac arrest refractory to conventional resuscitation maneuvers. This review paper aims to summarize key findings from the ECPR literature available to date as well as the recommendations for ECPR set forth by leading national and international resuscitation societies. Additionally, we describe the successful pediatric ECPR program at Texas Children's Hospital, highlighting the logistical, technical and educational features of the program.
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Affiliation(s)
- Taylor Olson
- Pediatric Critical Care Medicine, Children's National Hospital, Washington, DC, United States
| | - Marc Anders
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Pediatric Critical Care Medicine, Texas Children's Hospital, Houston, TX, United States
| | - Cole Burgman
- ECMO, Texas Children's Hospital, Houston, TX, United States
| | - Adam Stephens
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Congenital Heart Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Patricia Bastero
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Pediatric Critical Care Medicine, Texas Children's Hospital, Houston, TX, United States
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Ng PY, Ip A, Fang S, Lin JCR, Ling L, Chan KM, Leung KHA, Chan KCK, So D, Shum HP, Ngai CW, Chan WM, Sin WC. Effect of hospital case volume on clinical outcomes of patients requiring extracorporeal membrane oxygenation: a territory-wide longitudinal observational study. J Thorac Dis 2022; 14:1802-1814. [PMID: 35813733 PMCID: PMC9264048 DOI: 10.21037/jtd-21-1512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/10/2022] [Indexed: 11/06/2022]
Abstract
Background The utilization of extracorporeal membrane oxygenation (ECMO) has increased rapidly around the world. Being an overall low-volume high-cost form of therapy, the effectiveness of having care delivered in segregated units across a geographical locality is debatable. Methods All adult extracorporeal membrane oxygenation cases admitted to public hospitals in Hong Kong between 2010 and 2019 were included. “High-volume” centers were defined as those with >20 extracorporeal membrane oxygenation cases in the respective calendar year, while “low-volume” centers were those with ≤20. Clinical outcomes of patients who received extracorporeal membrane oxygenation care in high-volume centers were compared with those in low-volume centers. Results A total of 911 patients received extracorporeal membrane oxygenation—297 (32.6%) veno-arterial extracorporeal membrane oxygenation, 450 (49.4%) veno-venous extracorporeal membrane oxygenation, and 164 (18.0%) extracorporeal membrane oxygenation-cardiopulmonary resuscitation. The overall hospital mortality was 456 (50.1%). The annual number of extracorporeal membrane oxygenation cases in high- and low-volume centers were 29 and 11, respectively. Management in a high-volume center was not significantly associated with hospital mortality (adjusted odds ratio (OR) 0.86, 95% confidence interval (CI): 0.61–1.21, P=0.38), or with intensive care unit mortality (adjusted OR 0.76, 95% CI: 0.54–1.06, P=0.10) compared with a low-volume center. Over the 10-year period, the overall observed mortality was similar to the Acute Physiology And Chronic Health Evaluation IV-predicted mortality, with no significant difference in the standardized mortality ratios between high- and low-volume centers (P=0.46). Conclusions In a territory-wide observational study, we observed that case volumes in extracorporeal membrane oxygenation centers were not associated with hospital mortality. Maintaining standards of care in low-volume centers is important and improves preparedness for surges in demand.
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Affiliation(s)
- Pauline Yeung Ng
- Department of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China
| | - April Ip
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shu Fang
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Lowell Ling
- Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Man Chan
- Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | - Dominic So
- Department of Intensive Care, Princess Margaret Hospital, Hong Kong, China
| | - Hoi Ping Shum
- Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Chun Wai Ngai
- Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China
| | - Wai Ming Chan
- Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China
| | - Wai Ching Sin
- Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China.,Department of Anesthesiology, The University of Hong Kong, Hong Kong, China
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Puslecki M, Dabrowski M, Baumgart K, Ligowski M, Dabrowska A, Ziemak P, Stefaniak S, Szarpak L, Friedrich T, Szlanga L, Skorupa P, Steliga A, Hebel K, Andrejanczyk B, Ladzinska M, Wieczorek M, Puslecki L, Smereka J, Tukacs M, Swol J, Jemielity M, Perek B. Managing patients on extracorporeal membrane oxygenation support during the COVID-19 pandemic - a proposal for a nursing standard operating procedure. BMC Nurs 2021; 20:214. [PMID: 34717602 PMCID: PMC8556777 DOI: 10.1186/s12912-021-00736-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/17/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is effective in a selected critically ill patient population with promising results in refractory hypoxemia related to the novel coronavirus disease (COVID-19). However, it requires specialized clinicians and resources in advanced technology. Moreover, the COVID-19 remains an ongoing global emergency, and there is no evidence-based practice in preparedness. This article proposes an innovative and optimized nursing care protocol, the Standard Operating Procedure (SOP), that regulates safety and efficiency in using personal protective equipment (PPE) during ECMO-relevant procedures while providing ECMO therapy for patients with COVID-19. METHODS After performing a narrative literature search, we developed a high-fidelity translational simulation scenario. It included practicing appropriate donning and doffing PPE during work organization, ECMO-related procedures, and routine daily nursing care and management of ECMO over nine hours. In addition, we held supplementary constructive debrief meetings to consult international expert in the field. RESULTS A proposal for nursing standardized operating procedures was created, divided into categories. They included work organization, workload references, competences, infrastructural conditions, cannulation equipment, daily routine nursing care, and procedures during ECMO. CONCLUSIONS High-fidelity medical simulation can play an important role in staff training, improvement in previously gained proficiency, and development of optimal SOP for nursing care and management during ECMO in patients with COVID-19. Optimal SOPs may further guide multidisciplinary teams, including intensive care units and interventional departments.
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Affiliation(s)
- Mateusz Puslecki
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.
- Polish Society of Medical Simulation, Poznan, Poland.
| | - Marek Dabrowski
- Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Poznan, Poland
| | - Konrad Baumgart
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Ligowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Dabrowska
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Poznan, Poland
| | - Piotr Ziemak
- Polish Society of Medical Simulation, Poznan, Poland
| | - Sebastian Stefaniak
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Lukasz Szarpak
- Sklodowska-Curie Medical Academy, Warsaw, Poland
- Polish Society of Disaster Medicine, Wroclaw, Poland
| | | | - Lidia Szlanga
- Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Poznan, Poland
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Paulina Skorupa
- Department of Cardioanesthesia and Intensive Care, Medical University of Silesia, Zabrze, Poland
| | | | - Kazimiera Hebel
- Chair of Nursing and Medical Rescue, Pomeranian Academy, Slupsk, Poland
| | | | - Malgorzata Ladzinska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Lukasz Puslecki
- Department of International Management, Poznań University of Economics and Business, Poznan, Poland
| | - Jacek Smereka
- Department of Medical Rescue, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Tukacs
- Department of Cardiothoracic Intensive Care Unit/Nursing, New York Presbyterian - Columbia University Irving Medical Center, New York, NY, USA
| | - Justyna Swol
- Department of Respiratory Medicine, Allergology and Sleep Medicine, Intensive Care Unit, University Hospital of Paracelsus Medical University, Nuremberg, Germany
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
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Puslecki M, Dabrowski M, Ligowski M, Zakhary B, Said AS, Ramanathan K, Cooley E, Puslecki L, Stefaniak S, Ziemak P, Kiel-Puslecka I, Dabrowska A, Klosiewicz T, Sip M, Zalewski R, Ladzinska M, Mrowczynski W, Ladzinski P, Szlanga L, Baumgart K, Kupidlowski P, Szarpak L, Jemielity M, Perek B. Comprehensive assessment of a nationwide simulation-based course for artificial life support. PLoS One 2021; 16:e0257162. [PMID: 34618829 PMCID: PMC8496826 DOI: 10.1371/journal.pone.0257162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/24/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Successful implementation of medical technologies applied in life-threatening conditions, including extracorporeal membrane oxygenation (ECMO) requires appropriate preparation and training of medical personnel. The pandemic has accelerated the creation of new ECMO centers and has highlighted continuous training in adapting to new pandemic standards. To reach high standards of patients' care, we created the first of its kind, National Education Centre for Artificial Life Support (NEC-ALS) in 40 million inhabitants' country in the Central and Eastern Europe (CEE). The role of the Center is to test and promote the novel or commonly used procedures as well as to develop staff skills on management of patients needing ECMO. METHOD In 2020, nine approved and endorsed by ELSO courses of "Artificial Life Support with ECMO" were organized. Physicians participated in the three-day high-fidelity simulation-based training that was adapted to abide by the social distancing norms of the COVID-19 pandemic. Knowledge as well as crucial cognitive, behavioral and technical aspects (on a 5-point Likert scale) of management on ECMO were assessed before and after course completion. Moreover, the results of training in mechanical chest compression were also evaluated. RESULTS There were 115 participants (60% men) predominantly in the age of 30-40 years. Majority of them (63%) were anesthesiologists or intensivists with more than 5-year clinical experience, but 54% had no previous ECMO experience. There was significant improvement after the course in all cognitive, behavioral, and technical self-assessments. Among aspects of management with ECMO that all increased significantly following the course, the most pronounced was related to the technical one (from approximately 1.0 to more 4.0 points). Knowledge scores significantly increased post-course from 11.4 ± SD to 13 ± SD (out of 15 points). The quality of manual chest compression relatively poor before course improved significantly after training. CONCLUSIONS Our course confirmed that simulation as an educational approach is invaluable not only in training and testing of novel or commonly used procedures, skills upgrading, but also in practicing very rare cases. The implementation of the education program during COVID-19 pandemic may be helpful in founding specialized Advanced Life Support centers and teams including mobile ones. The dedicated R&D Innovation Ecosystem established in the "ECMO for Greater Poland" program, with developed National Education Center can play a crucial role in the knowledge and know-how transfer but future research is needed.
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Affiliation(s)
- Mateusz Puslecki
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Slupca, Poland
- * E-mail:
| | - Marek Dabrowski
- Polish Society of Medical Simulation, Slupca, Poland
- Chair and Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Ligowski
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Bishoy Zakhary
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR, United States of America
| | - Ahmed S. Said
- Division of Pediatric Critical Care Medicine, Washington University School of Medicine in St Louis and St Louis Children’s Hospital, St. Louis, Missouri, United States of America
| | - Kollengode Ramanathan
- Cardiothoracic Intensive Care Unit, National University Hospital, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Bond University, Robina, QLD, Australia
| | - Elaine Cooley
- Extracorporeal Life Support Organization, Ann Arbor, Michigan, United States of America
| | - Lukasz Puslecki
- Department of International Management, Poznan University of Economics and Business, Poznan, Poland
| | - Sebastian Stefaniak
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Ziemak
- Center of Medical Simulation, Poznan University of Medical Sciences, Poznan, Poland
| | - Ilona Kiel-Puslecka
- Center of Medical Simulation, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Dabrowska
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Polish Society of Medical Simulation, Slupca, Poland
| | - Tomasz Klosiewicz
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Sip
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Radoslaw Zalewski
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Ladzinska
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Mrowczynski
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Ladzinski
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Lidia Szlanga
- Polish Society of Medical Simulation, Slupca, Poland
| | - Konrad Baumgart
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Lukasz Szarpak
- Polish Society of Medical Simulation, Slupca, Poland
- Sklodowska-Curie Medical Academy, Warsaw, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
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Patient Safety during ECMO Transportation: Single Center Experience and Literature Review. Emerg Med Int 2021; 2021:6633208. [PMID: 33688436 PMCID: PMC7920709 DOI: 10.1155/2021/6633208] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background Extracorporeal membrane oxygenation (ECMO) has been proven to support in lifesaving rescue therapy. The best outcomes can be achieved in high-volume ECMO centers with dedicated emergency transport teams. Aim The aim of this study was to analyze the safety of ECMO support during medical transfer on the basis of our experience developed on innovation cooperation and review of literature. Methods A retrospective analysis of our experience of all ECMO-supported patients transferred from regional hospital of the referential ECMO center between 2015 and 2020 was carried out. Special attention was paid to transportation-related mortality and morbidity. Moreover, a systematic review of the Medline, Embase, Cochrane, and Google Scholar databases was performed. It included the original papers published before the end of 2019. Results Twelve (5 women and 7 men) critically ill ECMO-supported patients with the median age of 33 years (2-63 years) were transferred to our ECMO center. In 92% (n = 11) of the cases venovenous and in 1 case, venoarterial supports were applied. The median transfer length was 45 km (5-200). There was no mortality during transfer and no serious adverse events occurred. Of note, the first ECMO-supported transfer had been proceeded by high-fidelity simulations. For our systematic review, 68 articles were found and 22 of them satisfied the search criteria. A total number of 2647 transfers were reported, mainly primary (90%) and as ground transportations (91.6%). A rate of adverse events ranged from 1% through 20% but notably only major complications were mentioned. The 4 deaths occurred during transport (mortality 0.15%). Conclusions Our experiences and literature review showed that transportation for ECMO patients done by experienced staff was associated with low mortality rate but life-threatening adverse events might occur. Translational simulation is an excellent probing technique to improve transportation safety.
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Sip M, Puslecki M, Dabrowski M, Klosiewicz T, Zalewski R, Ligowski M, Goszczynska E, Paprocki C, Grygier M, Lesiak M, Jemielity M, Perek B. Extended cardiopulmonary resuscitation: from high fidelity simulation scenario to the first clinical applications in Poznan out-of-hospital cardiac arrest program. Perfusion 2020; 37:46-55. [PMID: 33325325 DOI: 10.1177/0267659120981811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The outcomes of out-of-hospital cardiac arrest (OHCA) patients are poor. In some OHCA cases, the reason is potentially reversible cardiac or aortic disease. It was suggested previously that high-quality cardiopulmonary resuscitation (CPR) followed by extracorporeal membrane oxygenation (ECMO) support may improve the grave prognosis of OHCA. However, extended CPR (ECPR) with ECMO application is an extremely invasive and cutting-edge procedure. The purpose of this article is to describe how high-fidelity medical simulation as a safe tool enabled implementation of the complex, multi-stage ECPR procedure. METHOD A high fidelity simulation of OHCA in street conditions was prepared and carried out as part of a ECPR procedure implemented in an in-hospital area. The simulation tested communication and collaboration of several medical teams from the pre-hospital to in-hospital phases along with optimal use of equipment in management of a sudden cardiac arrest (SCA) patient. RESULTS The critical and weak points of an earlier created scenario were collected into a simulation scenario checklist of ECPR algorithm architecture. A few days later, two ECPR procedures followed by cardiologic interventions for OHCA patients (one pulmonary artery embolectomy for acute pulmonary thrombosis and one percutaneous coronary artery angioplasty with drug eluting stent implantation for acute occlusion of the left anterior descending artery), were performed for the first time in Poland. The protocol was activated five times in the first 2 months of the POHCA Program. CONCLUSION High fidelity medical simulation in real-life conditions was confirmed to be a safe, useful tool to test and then implement the novel and complex medical procedures. It enabled to find, analyze and solve the weakest points of the earlier developed theoretical protocol and eventually succeed in clinical application of complete ECPR procedure.
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Affiliation(s)
- Maciej Sip
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Medical Simulation, Slupca, Poland
| | - Mateusz Puslecki
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Medical Simulation, Slupca, Poland.,Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | - Marek Dabrowski
- Polish Society of Medical Simulation, Slupca, Poland.,Department of Medical Education, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | - Tomasz Klosiewicz
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Medical Simulation, Slupca, Poland
| | - Radoslaw Zalewski
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Medical Simulation, Slupca, Poland
| | - Marcin Ligowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | - Ewa Goszczynska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | | | - Marek Grygier
- First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | - Maciej Lesiak
- First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | - Bartłomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
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Pang G, Futter C, Pincus J, Dhanani J, Laupland K. Development and testing of a low cost simulation manikin for extracorporeal cardiopulmonary resuscitation (ECPR) using 3-dimensional printing. Resuscitation 2020; 149:24-29. [DOI: 10.1016/j.resuscitation.2020.01.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/21/2020] [Accepted: 01/25/2020] [Indexed: 11/30/2022]
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9
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Malchesky PS. Artificial Organs 2018: A Year in Review. Artif Organs 2019; 43:288-317. [PMID: 30680758 DOI: 10.1111/aor.13428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 12/24/2022]
Abstract
In this Editor's Review, articles published in 2018 are organized by category and summarized. We provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level." Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer-reviewed special issues this year included contributions from the 13th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Undar, and the 25th Congress of the International Society for Mechanical Circulatory Support edited by Dr. Marvin Slepian. Additionally, many editorials highlighted the worldwide survival differences in hemodialysis and perspectives on mechanical circulatory support and stem cell therapies for cardiac support. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years.
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