Extracorporeal Membrane Oxygenation for COVID-19: Updated 2021 Guidelines from the Extracorporeal Life Support Organization
Extracorporeal Membrane Oxygenation for COVID-19: Updated 2021 Guidelines from the Extracorporeal Life Support Organization
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DOI：
10.1097/mat.0000000000001422
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发表时间：
2021-05-01
期刊：
影响因子：
4.2
通讯作者：
Brodie, Daniel
中科院分区：
文献类型：
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作者：
Badulak, Jenelle;Antonini, M. Velia;Brodie, Daniel
Disclaimer:This is an updated guideline from the Extracorporeal Life Support Organization (ELSO) for the role of extracorporeal membrane oxygenation (ECMO) for patients with severe cardiopulmonary failure due to coronavirus disease 2019 (COVID-19). The great majority of COVID-19 patients (>90%) requiring ECMO have been supported using venovenous (V-V) ECMO for acute respiratory distress syndrome (ARDS). While COVID-19 ECMO run duration may be longer than in non-COVID-19 ECMO patients, published mortality appears to be similar between the two groups.然而，数据收集仍在进行中，并且有信号表明总体死亡率可能正在上升。应使用 COVID-19 相关 ECMO 的常规选择标准；然而，当资源在大流行期间变得更加紧张时，就应该实施更严格的禁忌。 Formation of regional ECMO referral networks may facilitate communication, resource sharing, expedited patient referral, and mobile ECMO retrieval.没有数据表明在对 COVID-19 患者应用 ECMO 时与传统 ECMO 设备或患者管理存在偏差。在极少数情况下，儿童可能需要 ECMO 支持来治疗与 COVID-19 相关的 ARDS、心肌炎或多系统炎症综合征 (MIS-C)；传统的选择标准和管理实践应成为标准。我们强烈鼓励参与数据提交，以调查 ECMO 针对 COVID-19 的最佳使用。
Disclaimer:This is an updated guideline from the Extracorporeal Life Support Organization (ELSO) for the role of extracorporeal membrane oxygenation (ECMO) for patients with severe cardiopulmonary failure due to coronavirus disease 2019 (COVID-19). The great majority of COVID-19 patients (>90%) requiring ECMO have been supported using venovenous (V-V) ECMO for acute respiratory distress syndrome (ARDS). While COVID-19 ECMO run duration may be longer than in non-COVID-19 ECMO patients, published mortality appears to be similar between the two groups. However, data collection is ongoing, and there is a signal that overall mortality may be increasing. Conventional selection criteria for COVID-19-related ECMO should be used; however, when resources become more constrained during a pandemic, more stringent contraindications should be implemented. Formation of regional ECMO referral networks may facilitate communication, resource sharing, expedited patient referral, and mobile ECMO retrieval. There are no data to suggest deviation from conventional ECMO device or patient management when applying ECMO for COVID-19 patients. Rarely, children may require ECMO support for COVID-19-related ARDS, myocarditis, or multisystem inflammatory syndrome in children (MIS-C); conventional selection criteria and management practices should be the standard. We strongly encourage participation in data submission to investigate the optimal use of ECMO for COVID-19.