Abrams, Darryl and Garan, A. Reshad and Abdelbary, Akram and Bacchetta, Matthew and Bartlett, Robert H. and Beck, James and Belohlavek, Jan and Chen, Yih-Sharng and Fan, Eddy and Ferguson, Niall D. and Fowles, Jo-anne and Fraser, John and Gong, Michelle and Hassan, Ibrahim F. and Hodgson, Carol and Hou, Xiaotong and Hryniewicz, Katarzyna and Ichiba, Shingo and Jakobleff, William A. and Lorusso, Roberto and MacLaren, Graeme and McGuinness, Shay and Mueller, Thomas and Park, Pauline K. and Peek, Giles and Pellegrino, Vin and Price, Susanna and Rosenzweig, Erika B. and Sakamoto, Tetsuya and Salazar, Leonardo and Schmidt, Matthieu and Slutsky, Arthur S. and Spaulding, Christian and Takayama, Hiroo and Takeda, Koji and Vuylsteke, Alain and Combes, Alain and Brodie, Daniel (2018) Position paper for the organization of ECMO programs for cardiac failure in adults. INTENSIVE CARE MEDICINE, 44 (6). pp. 717-729. ISSN 0342-4642, 1432-1238
Full text not available from this repository. (Request a copy)Abstract
Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock, refractory ventricular arrhythmia, active cardiopulmonary resuscitation for cardiac arrest, and acute or decompensated right heart failure. Evidence is emerging to guide the use of this therapy for some of these indications, but there remains a need for additional evidence to guide best practices. As a result, the use of ECMO may vary widely across centers. The purpose of this document is to highlight key aspects of care delivery, with the goal of codifying the current use of this rapidly growing technology. A major challenge in this field is the need to emergently deploy ECMO for cardiac failure, often with limited time to assess the appropriateness of patients for the intervention. For this reason, we advocate for a multidisciplinary team of experts to guide institutional use of this therapy and the care of patients receiving it. Rigorous patient selection and careful attention to potential complications are key factors in optimizing patient outcomes. Seamless patient transport and clearly defined pathways for transition of care to centers capable of providing heart replacement therapies (e.g., durable ventricular assist device or heart transplantation) are essential to providing the highest level of care for those patients stabilized by ECMO but unable to be weaned from the device. Ultimately, concentration of the most complex care at high-volume centers with advanced cardiac capabilities may be a way to significantly improve the care of this patient population.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTRACORPOREAL MEMBRANE-OXYGENATION; MECHANICAL CIRCULATORY SUPPORT; REFRACTORY CARDIOGENIC-SHOCK; ACUTE MYOCARDIAL-INFARCTION; LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; ETHICAL DILEMMAS; HEART-FAILURE; PULMONARY; ARREST; Extracorporeal membrane oxygenation; Extracorporeal life support; Mechanical circulatory support; Cardiac failure; Cardiac arrest; Hospital organization; Critical care networks; Position article |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Mar 2020 08:31 |
| Last Modified: | 09 Mar 2020 08:31 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14436 |
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