Position paper for the organization of ECMO programs for cardiac failure in adults
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
29450594
DOI
10.1007/s00134-018-5064-5
PII: 10.1007/s00134-018-5064-5
Knihovny.cz E-zdroje
- Klíčová slova
- Cardiac arrest, Cardiac failure, Critical care networks, Extracorporeal life support, Extracorporeal membrane oxygenation, Hospital organization, Mechanical circulatory support, Position article,
- MeSH
- dospělí MeSH
- kardiogenní šok * MeSH
- lidé MeSH
- mimotělní membránová oxygenace * MeSH
- podpůrné srdeční systémy MeSH
- srdeční selhání * terapie MeSH
- transplantace srdce MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
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.
Australia and New Zealand Intensive Care Research Centre Monash University Melbourne Australia
Australian and New Zealand Intensive Care Research Centre Monash University Melbourne Australia
Cardiothoracic and Vascular ICU Auckland City Hospital Auckland New Zealand
Cardiothoracic ICU National University Health System Singapore Singapore
Critical Care Department Cairo University Cairo Egypt
Department of Anaesthesia and Intensive Care Papworth Hospital NHS Foundation Trust Cambridge UK
Department of Cardiology Fundación Cardiovascular de Colombia Bucaramanga Colombia
Department of Emergency Medicine Teikyo University Hospital Tokyo Japan
Department of Internal Medicine 2 University Hospital of Regensburg Regensburg Germany
Department of Surgery Columbia University Medical Center New York NY USA
Department of Surgery National Taiwan University Hospital Taipei Taiwan
Department of Surgery University of Michigan Ann Arbor MI USA
Department of Surgical Intensive Care Medicine Nippon Medical School Hospital Tokyo Japan
Division of Cardiac Vascular and Thoracic Surgery Columbia University Medical Center New York NY USA
Division of Cardiology Columbia University Medical Center New York NY USA
Division of Pediatric Cardiology Columbia University Medical Center New York NY USA
Extracorporeal Life Support Program Toronto General Hospital Toronto Canada
Hamad Medical Corporation Weill Cornell Medical College in Qatar Doha Qatar
Intensive Care Unit The Alfred Hospital Melbourne Australia
Keenan Research Center Li Ka Shing Knowledge Institute St Michael's Hospital Toronto Canada
Medical Research Institute of New Zealand Wellington New Zealand
Minneapolis Heart Institute Abbott Northwestern Hospital Minneapolis MN USA
Paediatric ICU Royal Children's Hospital Melbourne Australia
Physiotherapy Department The Alfred Hospital Melbourne Australia
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