Usefulness of the Yokohama Advanced Cardiopulmonary Help Team in patients with acute respiratory distress syndrome

Shusuke Utada; Hayato Taniguchi; Hiroshi Honzawa; Tomoaki Takeda; Takeru Abe; Ichiro Takeuchi

doi:10.1002/ams2.953

Usefulness of the Yokohama Advanced Cardiopulmonary Help Team in patients with acute respiratory distress syndrome

Acute Med Surg. 2024 Apr 23;11(1):e953. doi: 10.1002/ams2.953. eCollection 2024 Jan-Dec.

Authors

Shusuke Utada¹, Hayato Taniguchi¹, Hiroshi Honzawa¹, Tomoaki Takeda¹, Takeru Abe¹, Ichiro Takeuchi¹

Affiliation

¹ Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan.

Abstract

Aim: To evaluate whether establishing an extracorporeal membrane oxygenation (ECMO) specialist team, termed the Yokohama Advanced Cardiopulmonary Help Team (YACHT), affected the outcomes and centralization of patients requiring ECMO in Yokohama-Yokosuka regions.

Methods: This retrospective observational study included patients aged ≥18 years and treated with venovenous-ECMO for severe acute respiratory distress syndrome (ARDS) from 2014 to 2023. The primary outcome was intensive care unit (ICU) mortality. The secondary outcomes included ICU-, mechanical ventilator-, and ECMO-free days and complications during the first 28 days.

Results: This study included 46 (12 without- and 34 with-YACHT) patients. Among with-YACHT patients, 24 were transferred to our hospital from other hospitals, 14 were assessed by dispatched ECMO physicians, and 9 were transferred after ECMO introduction. No without-YACHT patients were transferred from other hospitals. With-YACHT patients experienced coronavirus disease 2019-associated respiratory failure more frequently (0 vs. 27, p < 0.001) and had higher Acute Physiology and Chronic Health Evaluation II scores (19 vs. 24, p = 0.037) and lower Respiratory Extracorporeal Membrane Oxygenation Survival Prediction scores (4 vs. 2, p = 0.021). ICU mortality was not significantly different between the groups (2 vs. 4, p = 0.67). ICU- (14 vs. 9, p = 0.10), ventilator- (11 vs. 5, p = 0.01), and ECMO-free days (20 vs. 14, p = 0.038) were higher before YACHT establishment. The incidences of complications were not significantly different between the groups.

Conclusions: Mortality was not significantly different pre- and post-YACHT establishment; however, it helped promote regionalization and centralization in Yokohama-Yokosuka areas. We will collect more cases to demonstrate YACHT's usefulness.

Keywords: Yokohama Advanced Cardiopulmonary Help Team; acute respiratory distress syndrome; coronavirus disease 2019; extracorporeal membrane oxygenation network; venovenous extracorporeal membrane oxygenation.