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Opatrný V, Třeška V, Zeithaml J, Hes O, Matějka R, Moláček J. Perfusion of a Kidney Graft from a Donor After Cardiac Death Based on Immediately Started Machine Perfusion: An Experimental Study on a Big Animal. Transplant Proc 2021; 53:2082-2090. [PMID: 34274120 DOI: 10.1016/j.transproceed.2021.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Donation after circulatory death donors are becoming a common source of organs for transplant. Despite good long-term outcomes of grafts from donation after circulatory death, this group is affected by a higher occurrence of delayed graft function and primary nonfunction. Our hypothesis is based on the assumption that washing the kidney grafts in the donor's body using a simple mechanical perfusion pump will result in faster and better perfusion of the parenchyma and more efficient cooling compared with hydrostatic perfusion alone. METHODS A total of 7 experimental animals (pigs) were used. The animals were divided into 2 groups: group A (n = 3) and group B (n = 4). After a 30-minute ischemic period for the selected kidney (clamped renal vessels), intra-arterial perfusion was performed. In group A perfusion was performed using hydrostatic pressure; in group B mechanical controlled perfusion was performed. After perfusion, declamping of the renal vessels caused restoration of flow. For graft quality evaluation, biopsy specimens were harvested, and the cooling speed was observed. Laboratory markers or renal failure were determined. RESULTS We found no significant differences between temperature drop and total diuresis between groups A and B. A significant difference was found between the groups in both flow parameters (flow maximum and mean flow) (P = .007, respectively P = .019). No laboratory parameters were found to be statistically significantly different. Histopathological analysis strongly supports the hypothesis of better flushing of kidney grafts using mechanical perfusion. CONCLUSIONS Based on our results, better kidney graft quality can be expected after immediately started mechanical perfusion in situ.
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Affiliation(s)
- Václav Opatrný
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic; Faculty of Medicine in Plzen, Transplantcentrum, Charles University, University Hospital in Plzen, Plzen, Czech Republic
| | - Vladislav Třeška
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic; Faculty of Medicine in Plzen, Transplantcentrum, Charles University, University Hospital in Plzen, Plzen, Czech Republic
| | - Jan Zeithaml
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic
| | - Ondřej Hes
- Sikl's Institute of Pathological Anatomy, University Hospital in Plzen, Plzen, Czech Republic
| | - Roman Matějka
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jiří Moláček
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic; Faculty of Medicine in Plzen, Transplantcentrum, Charles University, University Hospital in Plzen, Plzen, Czech Republic.
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2
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Zalewski R, Puślecki M, Kłosiewicz T, Sip M, Perek B. The use of prefilled adrenaline syringes improves cardiopulmonary resuscitation quality-high-fidelity simulator-based study. J Thorac Dis 2020; 12:2105-2112. [PMID: 32642114 PMCID: PMC7330414 DOI: 10.21037/jtd.2020.04.33] [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: 12/30/2019] [Accepted: 03/25/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND In some countries, adrenaline is available only in glass ampoules. However, simplification of cardiopulmonary resuscitation (CPR) by introducing prefilled syringes may ensure more efficient CPR. The aim of this study was to investigate the impact of different forms of adrenaline on the CPR quality. METHODS In a randomized cross-examination simulation study, 100 two-person paramedical teams took part in two 10-minute scenarios of sudden cardiac arrest (SCA) in a pulseless electrical activity mechanism (PEA). In the first scenario the set of medicines contained glass ampoules (group ST) with adrenaline, in the second prefilled syringes (group AMPS). The parameters of the CPR quality [correct number and depth of chest compressions (CC), no flow time, chest recoil, time to apply supraglottic airways device (SAD)] were compared. RESULTS In group AMPS the first dose of adrenaline was administered after 114.2±28.3 seconds after the initiation of CPR whereas after 178.1±62.6 seconds in group ST (P<0.001). Chest compression fraction (CCF) was higher (81.8%±6.1%) in group AMPS than in group ST (71.2%±7.5%). Paramedics performed CC at better frequency, to a preferred depth and in an appropriate place in group AMPS. Faster decision to apply SAD (131.7±34.0 s in group AMPS and 220.3±81.5 s in group ST) ensured faster achievement of airway patency in this group (181.5±48.7 vs. 271.2±101.5 s). CONCLUSIONS Prefilled syringes with crucial drugs during CPR may significantly improve the quality of CPR performed by two-person teams.
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Affiliation(s)
- Radosław Zalewski
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Mateusz Puślecki
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
| | - Tomasz Kłosiewicz
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Sip
- Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Bartłomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
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3
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Mihaylov P, Mangus R, Ekser B, Cabrales A, Timsina L, Fridell J, Lacerda M, Ghabril M, Nephew L, Chalasani N, Kubal CA. Expanding the Donor Pool With the Use of Extended Criteria Donation After Circulatory Death Livers. Liver Transpl 2019; 25:1198-1208. [PMID: 30929303 DOI: 10.1002/lt.25462] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/16/2019] [Indexed: 02/07/2023]
Abstract
Use of donation after circulatory death (DCD) donor livers for transplantation has remained cautious in the United States. The aim of this study was to demonstrate the expansion of a DCD liver transplantation (LT) program with the use of extended criteria donor (ECD) DCD livers. After institutional review board approval, 135 consecutive DCD LTs were retrospectively studied. ECD DCD livers were defined as those with 1 of the following factors: donor age >50 years, donor body mass index >35 kg/m2 , donor functional warm ischemia time >30 minutes, and donor liver macrosteatosis >30%. An optimization protocol was introduced in July 2011 to improve outcomes of DCD LT, which included thrombolytic donor flush and efforts to minimize ischemia times. The impact of this protocol on outcomes was evaluated in terms of graft loss, ischemic cholangiopathy (IC), and change in DCD LT volume. Of 135 consecutive DCD LTs, 62 were ECD DCDs. In total, 24 ECD DCD LTs were performed before (era 1) and 38 after the institution of optimization protocol (era 2), accounting for an increase in the use of ECD DCD livers from 39% to 52%. Overall outcomes of ECD DCD LT improved in era 2, with a significantly lower incidence of IC (5% versus 17% in era 1; P = 0.03) and better 1-year graft survival (93% versus 75% in era 1; P = 0.07). Survival outcomes for ECD DCD LT in era 2 were comparable to matched deceased donor LT. With the expansion of the DCD donor pool, the number of DCD LTs performed at our center gradually increased in era 2 to account for >20% of the center's LT volume. In conclusion, with the optimization of perioperative conditions, ECD DCD livers can be successfully transplanted to expand the donor pool for LT.
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Affiliation(s)
- Plamen Mihaylov
- Transplant Division, Indiana University School of Medicine, Indianapolis, IN
| | - Richard Mangus
- Transplant Division, Indiana University School of Medicine, Indianapolis, IN
| | - Burcin Ekser
- Transplant Division, Indiana University School of Medicine, Indianapolis, IN
| | - Arianna Cabrales
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Lava Timsina
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Jonathan Fridell
- Transplant Division, Indiana University School of Medicine, Indianapolis, IN
| | - Marco Lacerda
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
| | - Marwan Ghabril
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
| | - Lauren Nephew
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN
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Al Disi M, Alsalemi A, Alhomsi Y, Bensaali F, Amira A, Alinier G. Extracorporeal membrane oxygenation simulation-based training: methods, drawbacks and a novel solution. Perfusion 2018; 34:183-194. [DOI: 10.1177/0267659118802749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Patients under the error-prone and complication-burdened extracorporeal membrane oxygenation (ECMO) are looked after by a highly trained, multidisciplinary team. Simulation-based training (SBT) affords ECMO centers the opportunity to equip practitioners with the technical dexterity required to manage emergencies. The aim of this article is to review ECMO SBT activities and technology followed by a novel solution to current challenges. ECMO simulation: The commonly-used simulation approach is easy-to-build as it requires a functioning ECMO machine and an altered circuit. Complications are simulated through manual circuit manipulations. However, scenario diversity is limited and often lacks physiological and/or mechanical authenticity. It is also expensive to continuously operate due to the consumption of highly specialized equipment. Technological aid: Commercial extensions can be added to enable remote control and to automate circuit manipulation, but do not improve on the realism or cost-effectiveness. A modular ECMO simulator: To address those drawbacks, we are developing a standalone modular ECMO simulator that employs affordable technology for high-fidelity simulation.
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Affiliation(s)
- Mohammed Al Disi
- Department of Electrical Engineering, Qatar University, Doha, Qatar
| | | | - Yahya Alhomsi
- Department of Electrical Engineering, Qatar University, Doha, Qatar
| | - Fayçal Bensaali
- Department of Electrical Engineering, Qatar University, Doha, Qatar
| | - Abbes Amira
- Department of Computer Science and Engineering, Qatar University, Doha, Qatar
| | - Guillaume Alinier
- Ambulance Service, Hamad Medical Corporation, Doha, Qatar
- University of Hertfordshire, Hatfield, Herts, UK
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5
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Puślecki M, Ligowski M, Dąbrowski M, Stefaniak S, Ładzińska M, Ładziński P, Pawlak A, Zieliński M, Dąbrowska A, Artyńska A, Gezela M, Sobczyński P, Szarpak Ł, Perek B, Jemielity M. BEST Life-"Bringing ECMO Simulation To Life"-How Medical Simulation Improved a Regional ECMO Program. Artif Organs 2018; 42:1052-1061. [PMID: 30043501 DOI: 10.1111/aor.13332] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/26/2018] [Accepted: 06/22/2018] [Indexed: 01/02/2023]
Abstract
The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region. The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF), and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication. Finally, it promotes donation after circulatory death (DCD) strategy in selected organ donor cases. ECMO enables recovery of organs' function after unsuccessful lifesaving treatment. Because this organizational model is complex and expensive, we use advanced high-fidelity medical simulation to prepare for real-life implementation. During the first four months, we performed scenarios mimicking "ECMO for DCD," "ECMO for ECPR (extended cardiopulmonary resuscitation)," "ECMO for RRF" and "ECMO in hypothermia." It helped to create algorithms for aforementioned program arms. In the following months, three ECMO courses for five departments in Poznan (capitol city of Greater Poland) were organized and standardized operating procedures for road ECMO transportation within Medical Emergency System were created. Soon after simulation program, 38 procedures with ECMO perfusion therapy including five road transportations on ECMO were performed. The Maastricht category II DCD procedures were done four times on real patients and in two cases double successful kidney transplantations were carried out for the first time in Poland. ECMO was applied in two patients with hypothermia, nine adult patients with heart failure, and five with RRF, for the first time in the region. In the pediatric group, ECMO was applied in four patients with RRF and 14 with heart failure after cardiac surgery procedures. Additionally, one child was treated successfully following 200 km-long road transport on ECMO. We achieved good and promising results especially in VV ECMO therapy. Simulation-based training enabled us to build a successful procedural chain, and to eliminate errors at the stage of identification, notification, transportation, and providing ECMO perfusion therapy. We discovered the important role of medical simulation, not only to test the medical professional's skills, but also to promote ECMO therapy in patients with critical/life-threatening states. Moreover, it also resulted in increase of the potential organ pool from DCD in the Greater Poland region.
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Affiliation(s)
- Mateusz Puślecki
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Marcin Ligowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Marek Dąbrowski
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Simulation Medicine, Słupca, Poland
| | - Sebastian Stefaniak
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Małgorzata Ładzińska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Piotr Ładziński
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Clinical Hospital K. Jonscher, Poznan, Poland
| | - Aleksander Pawlak
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Clinical Hospital K. Jonscher, Poznan, Poland
| | - Marcin Zieliński
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Voivodeship Emergency Station, Poznan, Poland
| | - Agata Dąbrowska
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Simulation Medicine, Słupca, Poland
| | - Aniela Artyńska
- Department of Anesthesiology and Intensive Care, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Mariusz Gezela
- Department of Anesthesiology and Intensive Care, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Paweł Sobczyński
- Department of Anesthesiology and Intensive Care, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | | | - Bartłomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
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6
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Puslecki M, Ligowski M, Kiel M, Dabrowski M, Stefaniak S, Sip M, Maciejewski A, Dabrowska A, Kiel-Puslecka I, Kłosiewicz T, Misterski M, Buczkowski P, Szarpak L, Ruetzler K, Perek B, Czekajlo M, Jemielity M. Prototype of extracorporeal membrane oxygenation (ECMO) therapy simulator used in regional ECMO program. J Thorac Dis 2018; 10:5073-5079. [PMID: 30233882 DOI: 10.21037/jtd.2018.07.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Simulation is widely accepted as an important tool in training and educating healthcare providers. The first regional polish extracorporeal membrane oxygenation (ECMO) program called "ECMO for Greater Poland" was recently started. Methods We present a prototype for ECMO prepared for high-fidelity medical simulation in extracorporeal life support. ECMO therapy is a complex, difficult and expensive therapy in patient care. We have constructed an advanced ECMO simulation prototype, which can be used as a training tool in scenarios that prepare for real-life experiences. The "ECMO for Greater Poland" program uses high-fidelity simulation as a superior tool to simulate several complex clinical scenarios, and consequently train healthcare providers in rare, complicated and expensive procedures. The training course is standardized and allows repeatable training, improvement of skills, and an objective verification of trained skills. Results The ECMO simulation prototype is designed to replicate the physiological circulatory system and simulate several scenarios (i.e., bleeding, low pressure, occlusion, reaction for proper and incorrect pharmacological treatment). The electronic core control unit (CCU) with silicone tubes, artificial vessels (modified polyethylene) and analog components can be connected to an ECMO machine to emulate the human body during an ECMO simulation. If necessary, damaged and used parts can easily be replaced. The total cost of the simulator is approximately 450 and 50 USD for disposable parts. Conclusions This newly developed advanced ECMO simulation prototype was recently introduced into education and regularly training of healthcare providers of the "ECMO for Greater Poland" program. The simulation based training program is financially affordable and enables clinical teaching in a wider range of clinical scenarios. The ECMO simulation prototype consequently improves level of expertise of the healthcare providers and finally improves quality in patient care.
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Affiliation(s)
- Mateusz Puslecki
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
| | - Marcin Ligowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
| | | | - Marek Dabrowski
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Medical Simulation, Poznan, Poland
| | - Sebastian Stefaniak
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
| | - Maciej Sip
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Medical Simulation, Poznan, Poland
| | - Adrian Maciejewski
- Department of Medical Rescue, 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
| | - Ilona Kiel-Puslecka
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Tomasz Kłosiewicz
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Misterski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
| | - Piotr Buczkowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
| | - Lukasz Szarpak
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.,Lazarski University, Warsaw, Poland
| | - Kurt Ruetzler
- Departments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
| | - Michael Czekajlo
- Polish Society of Medical Simulation, Poznan, Poland.,Department of Surgery, Hunter Holmes McGuire VA Medical Center, Richmond, USA.,Lublin Medical University, Medical Simulation Center, Lublin, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.,Clinical Hospital SKPP, Poznan, Poland
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7
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Puślecki M, Ligowski M, Stefaniak S, Dąbrowski M, Zieliński M, Pawlak A, Kłosiewicz T, Sip M, Karczewski M, Małkiewicz T, Gąsiorowski Ł, Telec W, Ładzińska M, Baumgart K, Ładziński P, Perek B, Misterski M, Mrówczyński W, Sobczyński P, Kiel-Puślecka I, Buczkowski P, Kiel M, Czekajlo M, Jemielity M. "Extracorporeal Membrane Oxygenation for Greater Poland" Program: How to Save Lives and Develop Organ Donation? Transplant Proc 2018; 50:1957-1961. [PMID: 30177087 DOI: 10.1016/j.transproceed.2018.02.159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 02/06/2018] [Indexed: 01/09/2023]
Abstract
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.
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Affiliation(s)
- M Puślecki
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland; Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland.
| | - M Ligowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - S Stefaniak
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - M Dąbrowski
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland; Polish Society of Medical Simulation, Poland
| | - M Zieliński
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland; Voivodeship Medical Station, Poznan, Poland
| | - A Pawlak
- Polish Society of Medical Simulation, Poland
| | - T Kłosiewicz
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland; Polish Society of Medical Simulation, Poland
| | - M Sip
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland; Polish Society of Medical Simulation, Poland
| | - M Karczewski
- Department of Transplantology, General, Vascular and Plastic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - T Małkiewicz
- Department of Anesthesiology and Intensive Care, Poznan University of Medical Sciences, Clinical Hospital H, Święcickiego, Poznan, Poland
| | - Ł Gąsiorowski
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland; Polish Society of Medical Simulation, Poland; Poznan University of Medical Sciences, Center for Medical Simulation Poznan, Poznan, Poland
| | - W Telec
- Department of Medical Rescue, Poznan University of Medical Sciences, Poznan, Poland
| | - M Ładzińska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - K Baumgart
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - P Ładziński
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - B Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - M Misterski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - W Mrówczyński
- Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - P Sobczyński
- Department of Anesthesiology and Intensive Care, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - I Kiel-Puślecka
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - P Buczkowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
| | - M Kiel
- IT WORKS, Wrocław, Poland
| | - M Czekajlo
- Department of Surgery, Hunter Holmes McGuire VA Medical Center, Richmond, VA; Lublin Medical University, Lublin, Poland
| | - M Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Clinical Hospital SKPP, Poznan, Poland
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8
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The role of extracorporeal membrane oxygenation in patients after irreversible cardiac arrest as potential organ donors. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2018; 14:253-257. [PMID: 29354178 PMCID: PMC5767776 DOI: 10.5114/kitp.2017.72230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/26/2017] [Indexed: 11/17/2022]
Abstract
The number of people waiting for a kidney or liver transplant is growing systematically. Due to the latest advances in transplantation, persons after irreversible cardiac arrest and confirmation of death have become potential organ donors. It is estimated that they may increase the number of donations by more than 40%. However, without good organization and communication between pre-hospital care providers, emergency departments, intensive care units and transplantation units, it is almost impossible to save the organs of potential donors in good condition. Various systems, including extracorporeal membrane oxygenation (ECMO), supporting perfusion of organs for transplantation play a key role. In 2016 the "ECMO for Greater Poland" program was established. Although its main goal is to improve the survival rate of patients suffering from life-threatening cardiopulmonary conditions, one of its branches aims to increase the donation rate in patients with irreversible cardiac arrest. In this review, the role of ECMO in the latter group as the potential organ donors is presented.
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9
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Revolutionizing ECMO simulation with affordable yet high-Fidelity technology. Am J Emerg Med 2017; 36:1310-1312. [PMID: 29174451 DOI: 10.1016/j.ajem.2017.11.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 11/20/2022] Open
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