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Management of patients with impella devices or intra-aortic balloon pumps during helicopter air ambulance transport in observational data.
Connelly, Katherine M; Winslow, Stephanie E; Smith, Justin; Ahmad, Saad S; Xie, Changchun; Hinckley, William R; Gottula, Adam L; Lane, Bennett H.
Afiliação
  • Connelly KM; Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Winslow SE; UC Health Air Care & Mobile Care, Cincinnati, OH, USA.
  • Smith J; Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Ahmad SS; UC Health Air Care & Mobile Care, Cincinnati, OH, USA.
  • Xie C; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Hinckley WR; Department of Emergency Medicine, Indiana Univ School of Medicine, Indianapolis, IN, USA.
  • Gottula AL; Division of Cardiovascular Disease, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Lane BH; Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA.
Perfusion ; : 2676591231158273, 2023 Feb 17.
Article em En | MEDLINE | ID: mdl-36803325
INTRODUCTION: Placement of percutaneous ventricular support devices such as an intraaortic balloon pump (IABP) or Abiomed Impella device can treat severe cardiogenic shock. Critical care transport medicine (CCTM) providers frequently manage patients supported by these devices during interfacility transfers, often using a helicopter air ambulance (HAA). An understanding of patient needs and management during transport is essential to informing crew configuration and training, and this study adds to the limited existing data on the HAA transport of this complex patient population. METHODS: We performed a retrospective chart review of all HAA transports of patients with an IABP (n = 38) or Impella (n = 11) device at a single CCTM program from 2016 to 2020. We evaluated transport times and composite variables for the frequency of adverse events, condition changes requiring critical care evaluation, and critical care interventions. RESULTS: In this observational cohort, patients with an Impella device more frequently had an advanced airway and at least 1 vasopressor or inotrope active prior to transport. While flight times were similar, CCTM teams remained at referring facilities longer for patients with an Impella device (99 vs 68 minutes; p = 0.0097). Compared to patients with an IABP, patients with an Impella device more frequently had a condition change requiring critical care evaluation (100% vs 42%; p = 0.0005) and more frequently received critical care interventions (100% vs 53%; p = 0.0037). Adverse events were uncommon and did not differ for patients with an Impella device compared to an IABP (27% vs 11%; p = 0.178). CONCLUSION: Patients requiring mechanical circulatory support with IABP and Impella devices frequently require critical care management during transport. Clinicians should ensure the CCTM team has appropriate staffing, training, and resources to meet the critical care needs of these high acuity patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article