

Item type: | Article | ||||
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Journal or Publication Title: | Intensive Care Medicine | ||||
Publisher: | Springer | ||||
Place of Publication: | NEW YORK | ||||
Volume: | 44 | ||||
Number of Issue or Book Chapter: | 6 | ||||
Page Range: | pp. 717-729 | ||||
Date: | 2018 | ||||
Institutions: | Medicine > Lehrstuhl für Innere Medizin II | ||||
Identification Number: |
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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 | ||||
Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
Status: | Published | ||||
Refereed: | Yes, this version has been refereed | ||||
Created at the University of Regensburg: | Partially | ||||
Item ID: | 47113 |
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 ...

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.
Metadata last modified: 27 Aug 2024 05:37