Aeromedical Evacuation Using Extra Corporeal Life Support After Resuscitated Cardiac Arrest

BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad. CASE REPORT: In June, during a holiday in Turkey, a 56-yr-old woman complained about chest pain. She had a cardiac arrest and was resuscitated with no no-flow time in the local hospital. ECG showed ST segment elevation. Medic'Air International medical assistance (Paris, France) contacted the hospital, which was not equipped with coronarography or cardiac ultrasound and the local treating doctor refused transfer of the patient to another facility. A medical team completed by a cardiothoracic surgeon and a perfusionist went from Paris to the patient's bedside by air ambulance. They implemented the ECLS and successfully repatriated the patient to her home country (Belgium). The patient's condition improved, she neurologically improved, and returned home on the 14th day. DISCUSSION: Possible indications for ECLS repatriations firstly take into account recognized ECLS indications and case-by-case discussions on the evaluation of inadequacy of the health facilities and risk-benefit balance. In international medical assistance, this case's description is an example of repatriation for patients who previously could not be transferred due to high risk of such intervention.Gerard D, Raffin H, Lebreton G. Aeromedical evacuation using extra corporeal life support after resuscitated cardiac arrest. Aerosp Med Hum Perform. 2017; 88(4):431-433.