The use of mechanical circulatory support using percutaneous ventricular assist devices (pVAD) has increased rapidly during the last decade without substantial new evidence for their effect on outcome. In addition, many gaps in knowledge still exist such as timing and duration of support, haemodynamic monitoring, management of complications, concomitant medical therapy, and weaning protocols. This clinical consensus statement summarizes the consensus of an expert panel of the Association for Acute CardioVascular Care, European Society of Intensive Care Medicine, European Extracorporeal Life Support Organization, and European Association for Cardio-Thoracic Surgery. It provides practical advice regarding the management of patients managed with pVAD in the intensive care unit based on existing evidence and consensus on best current practice.

• Klíčová slova
• Association for Acute CardioVascular Care, Cardiogenic shock, European Association for Cardio-Thoracic Surgery, European Society of Intensive Care Medicine, Extracorporeal Life Support Organization, Mechanical circulatory support,
• MeSH
• dospělí MeSH
• hrudní chirurgie * MeSH
• jednotky intenzivní péče MeSH
• kardiogenní šok terapie   MeSH
• kardiologie * MeSH
• lidé MeSH
• mimotělní membránová oxygenace * metody   MeSH
• péče o pacienty v kritickém stavu MeSH
• podpůrné srdeční systémy * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The use of veno-arterial extracorporeal membrane oxygenation as extracorporeal cardiopulmonary resuscitation in patients suffering out-of-hospital cardiac arrest, largely increased in the last decade despite evidence supporting this practice being limited to non-randomized studies. However, between 2020 and 2023, four randomized studies were published comparing extracorporeal cardiopulmonary resuscitation to conventional cardiopulmonary resuscitation with controversial findings that triggered great debates. In this controversy, we discuss merits and pitfalls, and provide a critical interpretation of the available evidence from randomized trials on the use of extracorporeal cardiopulmonary resuscitation, with a particular focus on the recent multi-center INCEPTION trial.

• Klíčová slova
• ECLS, ECMO, ECPR, OHCA, extracorporeal cardiopulmonary resuscitation, extracorporeal life support, extracorporeal membrane oxygenation, out-of-hospital cardiac arrest,
• MeSH
• kardiopulmonální resuscitace * MeSH
• lidé MeSH
• mimotělní membránová oxygenace * škodlivé účinky   MeSH
• řeky MeSH
• retrospektivní studie MeSH
• zástava srdce mimo nemocnici * terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Introduction: Simulation training offers an authentic team-based learning opportunity without risk to real patients. The Educational Corner at the annual congress of the European Branch of Extracorporeal Life Support Organisation (EuroELSO) provided an opportunity for multiple simulation training sessions facilitated by experts from all over the world.Aim: We aimed to review the educational impact of EuroELSO Educational Corner and whether it provides a quality ECLS training to a wide spectrum of multidisciplinary international attendees utilising high and low fidelity simulation, workshops and hands on sessions.Methods: During the congress, 43 sessions were conducted dedicated to ECLS education with identified educational objectives. The sessions focused on management of adults and children on V-V or V-A ECMO. Adult sessions covered emergencies on mechanical circulatory support with management of LVAD and Impella, managing refractory hypoxemia on V-V ECMO, emergencies on ECMO, renal replacement therapy on ECMO, V-V ECMO, ECPR cannulation and performing perfect simulation. Paediatric sessions covered ECPR neck and central cannulation, renal replacement on ECMO, troubleshooting, cannulation workshop, V-V recirculation, ECMO for single ventricle, PIMS-TS and CDH, ECMO transport and neurological injury.Results: The Educational Corner was attended by more than 400 participants over the two congress days. Majority of responders (88%) reported that training sessions met the set educational goals and objectives and that this would change their current practice. Almost all (94%) reported that they received useful information and 95% would recommend the session to their colleagues.Conclusion: The Educational Corner, as an integral component of the annual EuroELSO congress, achieved the set educational goals and provided quality education based on the recipient survey. Structured multidisciplinary ECLS education with standardised curriculum and feedback is an important key step in delivering quality training to an international audience. Standardisation of European ECLS education remains an important focus of the EuroELSO.

• Klíčová slova
• education, extracorporeal cardiopulmonary resuscitation, extracorporeal life support, extracorporeal membrane oxygenation, mechanical life support,
• MeSH
• dítě MeSH
• dospělí MeSH
• kardiopulmonální resuscitace * MeSH
• lidé MeSH
• mimotělní membránová oxygenace * výchova   MeSH
• náhlé příhody MeSH
• tréninková simulace * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Londýn MeSH

INTRODUCTION: A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. METHODS: Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. RESULTS: 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within 1 hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0-14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. CONCLUSIONS: ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

• Klíčová slova
• ECLS, ECMO, extracorporeal life support, extracorporeal membrane oxygenation, geospatial analysis, regionalization,
• MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mimotělní membránová oxygenace * MeSH
• průřezové studie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

INTRODUCTION: An analysis on the ECLS use for patients with respiratory or cardiac support in COVID-19 based on an international response to EuroELSO survey, aims to generate a more comprehensive understanding of ECLS role during the recent viral pandemic. METHODS: EuroELSO announced the survey at the 10th annual congress in London, May 2022. The survey covered 26 multiple-choice questions. RESULTS: The survey returned 69 questionnaires from 62 centers across 22 European countries and seven centers across five non-European countries. Most of the centers providing ECLS for COVID-19 patients had more than 30 runs for respiratory support since December 2019. In the same period, at least 31 runs in adult COVID-19 patients have been performed in 48 of 69 centers (69.6%). The reported pediatric data from 18 centers is limited to less than the patients per center. CONCLUSION: Majority of the COVID-19 patients received respiratory ECLS support and adult patients dominated. The indications and contraindications are broadly aligned with available guidelines. Most of the centers considered age >65 or biological age as a relative or absolute contraindication for ECLS in COVID-19. ECLS withdrawal criteria in COVID-19 are controversial because the long-term outcomes after ECLS in COVID-19 and the impact of critical illness and the impact of long-COVID are still not known.

• Klíčová slova
• COVID-19, ECLS, ECMO, SARS-CoV-2, extracorporeal life support, extracorporeal membrane oxygenation,
• MeSH
• COVID-19 * epidemiologie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mimotělní membránová oxygenace * MeSH
• pandemie MeSH
• postakutní syndrom COVID-19 MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH