Do you know how much ECMO R & D costs are? How long is the R & D cycle? Do you know how hard it is to study medicine? Do you know how much human and material it takes to maintain this normal operation? Compared with the level of domestic mass consumption and the ability to bear medical costs, the cost of using ECMO is indeed high, but its operating cost is far from being reflected by these figures. Most (or almost all) of the cardiopulmonary bypass mechanical aids are used to keep patients alive at a loss.
When I think about the entry point to answer this question, I find a picture of the maque machine that is conservative for ten years. Listed on the list are the most basic configuration, can turn up to work to ensure the patient’s cardiopulmonary function, but can not guarantee very good results, if very good guarantee treatment, also need a lot of other peripheral resources to cooperate.
Let’s calculate the operating costs of the economy. Annual machine wear more than 170000. However, fewer than 100 patients a year in general (less than 800 heart operations and less than 0 comprehensive ICU beds) use ECMO every year, and a few generally, including heart failure waiting for transplantation, difficulty in weaning after cardiopulmonary bypass, Low cardiac output, cardiac arrest, pulmonary embolism, drowning, organophosphorus poisoning after transplantation.
In addition, ECMO is an advanced life support technology, its core is not only machine equipment, but also the medical staff around the equipment. The staffing can be divided into several categories: surgeon (can switch chest alone, establish cardiopulmonary bypass, free femoral arteriovenous bypass), cardiopulmonary bypass perfusion of two, the treatment of ECMO and patients with a certain technical accumulation of senior personnel; More than one intensive care physician who can plan the treatment plan with an extracorporeal perfusion specialist; three specialist nurses (on shift).
In addition, the patients with ECMO should routinely detect the coagulation indexes such as ACTA APTTT INR, at least one dynamic (static) pulse blood gas analysis, erythrocyte, platelet measurement and so on for at least three hours. If these indicators show abnormal or abnormal trends to be corrected in a timely manner will involve the corresponding treatment costs. In addition, as mechanical assistance can wear out the patient’s platelet, coagulation factors, and so on, patients almost daily need a person’s platelets, and 200-600ml fresh plasma.
The cost problem is an important factor restricting the development and popularization of ECMO technology. Taiwan and I have been used in Southeast China more widely, many drowning, pulmonary embolism patients are the first time the support of ECMO, waiting for further treatment, have achieved good results. I hope that our health care department will pay attention to our medical center to introduce our patients and families understand. Let more life things to life related, economic to the society, so that more people in need of assistance.