Best evidence summary for safety management of inter-hospital transport of patients on extracorporeal membrane oxygenation

doi:10.3761/j.issn.0254-1769.2023.10.015

Abstract

Abstract:

Objective To retrieve，evaluate and summarize relevant evidence of safety management of inter-hospital transport in patients on extracorporeal membrane oxygenation（ECMO），so as to provide references for clinical practice. Methods We searched BMJ Best Practice，UpToDate，Joanna Briggs Institute，Guidelines International Network，Agency for Healthcare Research and Quality，Canadian Medical Association CPG Infobase，Cochrane Library，Yimaitong，Extracorporeal Life Support Organization Website，PubMed，Web of Science，CINAHL，Embase，MEDLINE，CNKI，Wanfang database and VIP database on all evidence related to the management of inter-hospital transport in patients on ECMO，including clinical decisions，guidelines，evidence summaries，best practices，expert consensuses，systematic reviews and meta-analysis. The retrieval time limit is from the establishment to September 2022. There were 4 investigators who independently assessed the quality of the literature，and also extracted，integrated and graded the evidence from the included literature. Results Totally 13 articles were included，involving 2 guidelines，8 expert consensuses and 3 systematic reviews. Finally，37 pieces of best evidence were summarized from 4 dimensions，namely team composition，response and preparation，transportation practice，management and quality control. Conclusion This study summarized the best evidence which can provide a basis for the implementation of inter-hospital transport supported by ECMO to promote patient safety during inter-hospital transport.

Key words: Extracorporeal Membrane Oxygenation, Inter-Hospital Transport, Transportation of Patients, Safety Management, Evidence-Based Nursing

摘要：

目的评价并总结体外膜肺氧合支持下患者院际转运安全管理的相关证据，为临床实践提供依据。方法系统检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南协作网、美国卫生保健质量与研究机构网站、加拿大医学会临床实践指南库、Cochrane Library、医脉通指南网、体外生命支持组织网站、PubMed、Web of Science、CINAHL、Embase、中国知网、维普数据库、万方数据库中关于体外膜肺氧合支持下患者院际转运管理的相关证据，包括临床决策、指南、证据总结、最佳实践、专家共识、推荐意见、系统评价及Meta分析，检索时限为建库至2022年9月。由4名研究者独立进行文献质量评价和资料提取。结果共纳入13篇文献，其中指南2篇、专家共识8篇、系统评价3篇。从团队组成、响应和准备、转运实践、管理和质量控制4个方面总结了37条证据。结论该研究总结了体外膜肺氧合支持下患者院际转运安全管理的最佳证据，为临床开展院际转运实践提供依据。

关键词: 体外膜肺氧合, 院际转运, 患者转运, 安全管理, 循证护理学

YU Anqi, DENG Juan, ZHOU Xinyu, YAN Li, HUANG Sufang, ZHANG Meng, WANG Yi, XIONG Jie. Best evidence summary for safety management of inter-hospital transport of patients on extracorporeal membrane oxygenation[J]. Chinese Journal of Nursing, 2023, 58(10): 1245-1252.

余安琪, 邓娟, 周欣宇, 严丽, 黄素芳, 张梦, 王逸, 熊杰. 体外膜肺氧合支持下患者院际转运安全管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(10): 1245-1252.

Figures/Tables 4

References 31

[1]	高冬, 黄霞, 贾培培, 等. 体外膜肺氧合专科护士核心能力特征要素的质性研究[J]. 中华护理杂志, 2021, 56(12):1783-1788. DOI URL
	Gao D, Huang X, Jia PP, et al. A qualitative research on the characteristics of core competence of ECMO specialist nurses[J]. Chin J Nurs, 2021, 56(12):1783-1788. DOI URL
[2]	苑志勇, 韩小宁, 周维桂, 等. 体外生命支持中心建设对体外膜氧合技术治疗患者预后研究[J]. 中华急诊医学杂志, 2022, 31(11):1526-1529.
	Yuan ZY, Han XN, Zhou WG, et al. Study on the prognosis of patients treated with extracorporeal membrane oxygenation by the construction of extracorporeal life support center[J]. Chin J Emerg Med, 2022, 31(11):1526-1529.
[3]	张文稳, 秦秉玉, 越丽霞, 等. 体外膜肺氧合区域救治模式在重症心肺疾病患者中的应用[J]. 中华危重病急救医学, 2021, 33(5):596-599.
	Zhang WW, Qin BY, Yue LX, et al. Application of extracorporeal membrane oxygenation regional treatment pattern in patients with severe cardiopulmonary diseases[J]. Chin Crit Care Med, 2021, 33(5):596-599.
[4]	Fletcher-Sandersjöö A, Frenckner B, Broman M. A single-center experience of 900 interhospital transports on extracorporeal membrane oxygenation[J]. Ann Thorac Surg, 2019, 107(1):119-127. DOI PMID
[5]	Ericsson A, Frenckner B, Broman LM. Adverse events during inter-hospital transports on extracorporeal membrane oxygenation[J]. Prehosp Emerg Care, 2017, 21(4):448-455. DOI PMID
[6]	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21):1991-1994.
	Zhu Z, Hu Y, Xing WJ, et al. The composition of different types of evidence-based problems[J]. J Nurses Train, 2017, 32(21):1991-1994.
[7]	Hoffmann-Eβer W, Siering U, Neugebauer EA, et al. Guideline appraisal with AGREE Ⅱ:systematic review of the current evi-dence on how users handle the 2 overall assessments[J]. PLoS One, 2017, 12(3):e0174831.
[8]	Joanna Briggs Institute. Critical appraisal tools[EB/OL].[2022-11-18]. https://jbi.global/critical-appraisal-tools.
[9]	Labib A, August E, Agerstrand C, et al. Extracorporeal life support organization guideline for transport and retrieval of adult and pediatric patients with ECMO support[J]. ASAIO J, 2022, 68(4):447-455. DOI PMID
[10]	中国医药教育协会急诊专业委员会, 中华医学会急诊分会复苏学组, 中国急诊体外膜肺氧合联盟. 成人体外膜肺氧合患者院际转运专家共识[J]. 中华急诊医学杂志, 2020, 29(2):165-170.
	Emergency Professional Committee of Chinese Medical Education Association, Recovery Group of Emergency Branch of the Chinese Medical Association, Chinese Emergency Extracorporeal Membrane Oxygenation Union. Expert consensus on inter-hospital transport of adult patients with extracorporeal membrane oxygenation[J]. Chin J Emerg Med, 2020, 29(2):165-170.
[11]	中国医师协会呼吸医师分会危重症医学专业委员会, 中华医学会呼吸病学分会危重症医学学组. 体外膜式氧合治疗成人重症呼吸衰竭推荐意见[J]. 中华结核和呼吸杂志, 2019, 42(9):660-684.
	Committee of Critical Care Medicine,Chinese Association of Chest Physician, Chinese Medical Doctor Association;Critical Care Medicine Group, Chinese Thoracic Society,Chinese Medical Association. Recommendation of extracorporeal membrane oxygenation in the treatment of severe respiratory failure in adults[J]. Chin J Tuberc Respir Dis, 2019, 42(9):660-684.
[12]	Argudo E, Hernández-Tejedor A, Belda Hofheinz S, et al. Spa-nish society of intensive and critical care medicine and coronary units(SEMICYUC) and the Spanish society of pediatric intensive care(SECIP) consensus recommendations for ECMO transport[J]. Med Intensiva(Engl Ed), 2022, 46(8):446-454.
[13]	中国医师协会体外生命支持专业委员会. 成人体外膜氧合循环辅助专家共识[J]. 中华医学杂志, 2018, 98(12):886-894.
	Extracorporeal Life Support Committee of Chinese Physician Association. Consensus on extracorporeal membrane oxygenation for circulatory support in adults[J]. Natl Med J China, 2018, 98(12):886-894.
[14]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
	Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 edition)[J]. J Nurses Train, 2015, 30(11):964-967.
[15]	Ann Arbor MI. ELSO guidelines for cardiopulmonary extracorporeal life support. Extracorporeal life support organization,version1.4[EB/OL].(2017-09-18)[2022-11-18]. https://www.elso.org/Portals/0/ELSO%20Guidelines%20General%20All%20ECLS%20Version%201_4.pdf.
[16]	李文玉, 孙彩霞, 王红霞, 等. 新型冠状病毒肺炎危重患者体外膜肺氧合治疗护理方案[J]. 中华护理杂志, 2020, 55(增刊):193-198.
	Li WY, Sun CX, Wang HX, et al. Nursing protocol on extracorporeal membrane pulmonary oxygenation therapy for critical patients with coronavirus disease 2019[J]. Chin J Nurs, 2020, 55(Supple):193-198.
[17]	Abrams D, Garan AR, Abdelbary A, et al. Position paper for the organization of ECMO programs for cardiac failure in adults[J]. Intensive Care Med, 2018, 44(6):717-729. DOI PMID
[18]	Alain C, Daniel B, Robert B, et al. Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients[J]. Am J Respir Crit Care Med, 2014, 190(5):488-96. DOI URL
[19]	Fernández-Mondéjar E, Fuset-Cabanes MP, Grau-Carmona T, et al. The use of ECMO in ICU. Recommendations of the Spanish society of critical care medicine and coronary units[J]. Med Intensiva(Engl Ed), 2019, 43(2):108-120.
[20]	Puslecki M, Baumgart K, Ligowski M, et al. Patient safety dur-ing ECMO transportation:single center experience and literature review[J]. Emerg Med Int, 2021, 2021:6633208.
[21]	Mendes PV, de Albuquerque Gallo C, Besen BAMP, et al. Trans-portation of patients on extracorporeal membrane oxygenation:a tertiary medical center experience and systematic review of the literature[J]. Ann Intensive Care, 2017, 7(1):14. DOI URL
[22]	Bryner B, Cooley E, Copenhaver W, et al. Two decades’ experience with interfacility transport on extracorporeal membrane oxygenation[J]. Ann Thorac Surg, 2014, 98(4):1363-1370. DOI URL
[23]	鲁鑫, 江智霞, 胥露, 等. 护士参与体外膜肺氧合监护培训的进展及启示[J]. 中华护理杂志, 2022, 57(4):502-506. DOI URL
	Lu X, Jiang ZX, Xu L, et al. Progress and enlightenment of ECMO training at home and abroad[J]. Chin J Nurs, 2022, 57(4):502-506. DOI URL
[24]	Puslecki M, Ligowski M, Dᶏbrowski M, et al. Development of regional extracorporeal life support system:the importance of innovative simulation training[J]. Am J Emerg Med, 2019, 37(1):19-26. DOI
[25]	杨硕, 鲁玫, 刘芳, 等. 体外膜肺氧合转运车的设计与应用[J]. 中华危重病急救医学, 2022, 34(7):759-761.
	Yang S, Lu M, Liu F, et al. Design and application of extracorporeal membrane oxygenation transport vehicle[J]. Chin Crit Care Med, 2022, 34(7):759-761.
[26]	周荣, 蔡文智, 詹斌, 等. 1例体外膜肺氧合治疗心肌梗死患者航空转运的护理[J]. 中华护理杂志, 2018, 53(11):1399-1400.
	Zhou R, Cai WZ, Zhan B, et al. Nursing care of one patient with myocardial infarction treated by ECMO continuously and transferred by medical helicopter[J]. Chin J Nurs, 2018, 53(11):1399-1400.
[27]	Muller G, Flecher E, Lebreton G, et al. The ENCOURAGE mor-tality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock[J]. Intensive Care Med, 2016, 42(3):370-378. DOI URL
[28]	Broman LM, Holzgraefe B, Palmér K, et al. The Stockholm experience:interhospital transports on extracorporeal membrane oxygenation[J]. Crit Care, 2015, 19(1):278. DOI URL
[29]	高冬, 黄霞, 贾培培, 等. 护士应用体外膜肺氧合技术核心能力评价指标的构建[J]. 中华护理杂志, 2022, 57(18):2239-2246.
	Gao D, Huang X, Jia PP, et al. Construction of a core competence evaluation index system for nurses participating in ECMO technology[J]. Chin J Nurs, 2022, 57(18):2239-2246.
[30]	张晓波, 冯瑞, 葛小玲, 等. 基于5G+区块链的危重新生儿转运信息平台构建策略与效果评估[J]. 中国卫生资源, 2022, 25(5):581-587.
	Zhang XB, Feng R, Ge XL, et al. Construction strategy and effect evaluation of critical newborn transport information platform based on 5G+ blockchain[J]. Chin Health Resour, 2022, 25(5):581-587.
[31]	高洁, 梁影, 黑飞龙. 体外膜肺氧合转运网络建设及转运工作开展的现状与前景[J]. 中国急救医学, 2020, 40(10):1016-1019.
	Gao J, Liang Y, Hei FL. Current status and prospects of ECMO transport network construction and transport network[J]. Chin J Crit Care Med, 2020, 40(10):1016-1019.