Mobile ECMO team for inter-hospital transportation of patients with ARDS: a retrospective case series.

INTRODUCTION: Transport of patients undergoing extracorporeal membrane oxygenation is currently available in 5 referral centers in our country. METHODS: Retrospective case series of patients managed by our mobile extracorporeal membrane oxygenation team and transferred to San Gerardo University Hospital from December 2004 to December 2012. RESULTS: 42 patients were transported. The mean age was 42.11 (standard deviation ±18.11) years, with a range between 2 years and 70. 14 patients were females (33%) and 28 males (67%). The average transport distance was 121.69 km (±183.08) with a range between 9 km and 1044 Km. The mission's mean time was equal to 508 minutes (±185) with range of 120-960 minutes. 29 patients (69%) were transported with extracorporeal membrane oxygenation support, while 13 patients (31%) were transported with conventional ventilation. In 28 patients (97%) a veno-venous bypass was utilized, while in one case (3%) a Veno-Arterial cannulation was performed. 32 patients survived (76%) and have been discharged alive from hospital. No major clinical or technical issues were observed during the transport. CONCLUSIONS: According to our data, we conclude that a dedicated mobile team allowed safe ground transportation of patients with severe acute lung injury to our tertiary care institution.

Location of the site of bacterial bile-salt deconjugation by combining abdominal scintigraphy with expired C-14.

A combined 14CO2 bile-salt breath and scintigraphic test has proved useful in determining the site of bile-salt deconjugation by bacteria. Data suggest that the procedure can be shortened to less than 8 hr with Tc-99m sulfur colloid abdominal scintigrams added to locate the labeled meal. Moreover the cumulative 14CO2 excretion, which is an indes of the rate of bile-salt deconjugation, gives clearer separation than peak specific activity between normals and either high or low deviations from normal, The test should be helpful in a number of difficult diagnostic problems involving chronic diarrhea, and offers as well both as well both a guide to appropriate therapy and a monitor for relapse in enfected blind-loop syndromes,