Patients undergoing extracorporeal membrane oxygenation (ECMO) are critically ill and show high mortality. Inter-hospital transfer of these patients has to be safe, with high survival rates during transport without potentially serious and life-threatening adverse events. The Swiss Air-Rescue provides 24-h/7-days per week inter-hospital helicopter transfers that include on-site ECMO cannulation if needed. This retrospective observational study describes adverse events of patients on ECMO transported by helicopter, and their associated survival. All patients on ECMO with inter-hospital transfer by helicopter from start of service in February 2009 until May 2021 were included. Patients not transported by helicopter or with missing medical records were excluded. Patient demographics (age, sex) and medical history (type of and reason for ECMO), mission details (flight distance, times, primary or secondary transport), adverse events during the inter-hospital transfer, and survival of transferred patients were recorded. The primary endpoint was patient survival during transfer. Secondary endpoints were adverse events during transfer and 28-day survival. We screened 214 ECMO-related missions and included 191 in this analysis. Median age was 54.6 [IQR 46.1–62.0] years, 70.7% were male, and most patients had veno-arterial ECMO (56.5%). The main reasons for ECMO were pulmonary (46.1%) or cardiac (44.0%) failure. Most were daytime (69.8%) and primary missions (n = 100), median total mission time was 182.0 [143.0–254.0] min, and median transfer distance was 52.7 [33.2–71.1] km. All patients survived the transfer. Forty-four adverse events were recorded during 37 missions (19.4%), where 31 (70.5%) were medical and none resulted in patient harm. Adverse events occurred more frequently during night-time missions (59.9%, p = 0.047). Data for 28-day survival were available for 157 patients, of which 86 (54.8%) were alive. All patients under ECMO survived the helicopter transport. Adverse events were observed for about 20% of the flight missions, with a tendency during the night-time flights, none harmed the patients. Inter-hospital transfer for patients undergoing ECMO provided by 24-h/7-d per week helicopter emergency medical service teams can be considered as feasible and safe. The majority of the patients (54.8%) were still alive after 28 days.

中文翻译：

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体外膜肺氧合患者的直升机医院间转运：一项服务系统的 12 年回顾性分析

接受体外膜肺氧合（ECMO）的患者病情危重，死亡率很高。这些患者的医院间转移必须是安全的，在运输过程中具有高存活率，没有潜在的严重和危及生命的不良事件。Swiss Air-Rescue 提供每周 7 天 24 小时的医院间直升机转运服务，如果需要，包括现场 ECMO 插管。这项回顾性观察研究描述了直升机运送的 ECMO 患者的不良事件及其相关生存率。包括从 2009 年 2 月开始服务到 2021 年 5 月期间通过直升机进行医院间转移的所有 ECMO 患者。未由直升机运送或医疗记录缺失的患者被排除在外。患者人口统计学（年龄、性别）和病史（ECMO的类型和原因），记录任务细节（飞行距离、时间、主要或次要运输）、医院间转移期间的不良事件以及转移患者的生存情况。主要终点是转移期间的患者存活率。次要终点是转移期间的不良事件和 28 天生存期。我们筛选了 214 项与 ECMO 相关的任务，并将 191 项纳入本次分析。中位年龄为 54.6 [IQR 46.1–62.0] 岁，70.7% 为男性，大多数患者接受了静脉-动脉 ECMO（56.5%）。ECMO的主要原因是肺（46.1%）或心脏（44.0%）衰竭。大多数是白天 (69.8%) 和主要任务 (n = 100)，总任务时间中位数为 182.0 [143.0–254.0] 分钟，中位转移距离为 52.7 [33.2–71.1] 公里。所有患者都在转移中幸存下来。在 37 次任务中记录了 44 起不良事件（19.4%），其中 31 起（70. 5%）是医疗的，没有人对患者造成伤害。夜间任务期间不良事件发生的频率更高（59.9%，p = 0.047）。157 名患者可获得 28 天生存数据，其中 86 名（54.8%）存活。ECMO下的所有患者都在直升机运输中幸存下来。大约 20% 的飞行任务出现了不良事件，在夜间飞行中有趋势，没有对患者造成伤害。每周 7 天 24 小时/7 天的直升机紧急医疗服务团队为接受 ECMO 的患者提供医院间转运被认为是可行和安全的。大多数患者（54.8%）在 28 天后仍然存活。其中 86 人（54.8%）还活着。ECMO下的所有患者都在直升机运输中幸存下来。大约 20% 的飞行任务出现了不良事件，在夜间飞行中有趋势，没有对患者造成伤害。每周 7 天 24 小时/7 天的直升机紧急医疗服务团队为接受 ECMO 的患者提供医院间转运被认为是可行和安全的。大多数患者（54.8%）在 28 天后仍然存活。其中 86 人（54.8%）还活着。ECMO下的所有患者都在直升机运输中幸存下来。大约 20% 的飞行任务出现了不良事件，在夜间飞行中有趋势，没有对患者造成伤害。每周 7 天 24 小时/7 天的直升机紧急医疗服务团队为接受 ECMO 的患者提供医院间转运被认为是可行和安全的。大多数患者（54.8%）在 28 天后仍然存活。