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Collective aeromedical transport of COVID-19 critically ill patients in Europe: A retrospective study - 24/03/21

Doi : 10.1016/j.accpm.2020.11.004 
Jean Turc a, b, , Henri-Louis Dupré c, Madeleine Beaussac d, Sophie Murris e, Lionel Koch f, Raphael Paris g, Julia Di Filippo d, Berangère Distinguin h, Violaine Muller i, Mathieu Boutonnet i
a Military Teaching Hospital Desgenettes, Intensive Care Unit and Anaesthesiology Department, 69003 Lyon, France 
b Edouard Herriot Hospital, Intensive Care Unit and Anaesthesiology Department, Hospices Civils de Lyon, 69437 Lyon, France 
c Military Teaching Hospital Saint-Anne, Intensive Care Unit and Anaesthesiology Department, 83000 Toulon, France 
d 160th Military Medical Unit, Istres, France 
e 148th Military Medical Unit, 83400 Hyeres, France 
f French Armed Forces Biomedical Research Institute (IRBA), Bacteriology Unit, 91220 Bretigny sur Orge, France 
g Military Teaching Hospital Laveran, Intensive Care Unit and Anaesthesiology Department, 13000 Marseille, France 
h 158th Military Medical Unit, 13661 Salon de Provence, France 
i Military Teaching Hospital Percy, Intensive Care Unit and Anaesthesiology Department, Clamart, France 

Corresponding author at: Edouard Herriot Hospital, Intensive Care Unit and Anaesthesiology Department, Hospices Civils de Lyon, 69437 Lyon, France.Edouard Herriot Hospital, Intensive Care Unit and Anaesthesiology Department, Hospices Civils de LyonLyon69437France

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Abstract

Background

In early 2020, the coronavirus disease 2019 (COVID-19) pandemic outbreak has posed the risk of critical care resources overload in every affected country. Collective interhospital transport of critically ill COVID-19 patients as a way to mitigate the localised pressure from overloaded intensive care units at a national or international level has not been reported yet. The aim of this study was to provide descriptive data about the first six collective aeromedical evacuation (MEDEVAC) of COVID-19 patients performed within Europe.

Methods

This retrospective study included all adult patients transported by the first six collective MEDEVAC missions for COVID-19 patients performed within Europe on the 18th, 21st, 24th, 27th, 31st of March and the 3rd of April 2020.

Results

Thirty-six patients with acute respiratory distress syndrome (ARDS) were transported aboard six MEDEVAC missions. The median duration of mechanical ventilation in ICU before transportation was 4 days (3−5.25). The median PaO2/FiO2 ratio obtained before, during the flight and at day 1 after the transport was 180 mmHg (156–202,5), 143 mmHg (118,75–184,75) and 174 mmHg (129,5–205,5), respectively, with no significant difference. The median norepinephrine infusion rate observed before, during the flight and at day 1 after the transport was 0,08 µg/kg-1. min-1 (0,00-0,20), 0,08 (0,00-0,25), and 0,07 (0,03-0,18), respectively, with no significant difference. No life-threatening event was reported.

Conclusion

Collective aero-MEDEVAC of COVID-19 critically ill patients could provide a reliable solution to help control the burden of the disease at a national or international level.

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Abbreviations : ARDS, COVID-19, ICU, MEDEVAC, MoRPHEE, PEEP, PBW, SARS-CoV-2, SOFA

Keywords : Acute respiratory distress syndrome, Aeromedical evacuation, Interhospital transport, COVID-19, Mechanical ventilation


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© 2020  Société française d'anesthésie et de réanimation (Sfar). Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 40 - N° 1

Artículo 100786- février 2021 Regresar al número
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