Regional Planning for Extracorporeal Membrane Oxygenation Allocation During Coronavirus Disease 2019
Regional Planning for Extracorporeal Membrane Oxygenation Allocation During Coronavirus Disease 2019
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DOI：
10.1016/j.chest.2020.04.026
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发表时间：
2020-08-01
期刊：
影响因子：
9.6
通讯作者：
Hick, John L.
中科院分区：
文献类型：
--
作者：
Prekker, Matthew E.;Brunsvold, Melissa E.;Hick, John L.
面对2019冠状病毒病（COVID-19）大流行，卫生系统必须为ICU需求的激增做好计划，并公平分配资源，以在资源稀缺期间为重症患者和公众带来最大利益。例如，可以通过积极主动的区域计划来减少发病率和死亡率，以便对机械呼吸机进行分类。体外膜肺氧合（ECMO）是严重呼吸衰竭的一种资源密集型和潜在的救生方式，直到最近才被纳入积极的灾害准备。本文探讨了潜在的假设和分类原则，可以指导ECMO资源整合到现有的灾害规划。本文借鉴了美国一个拥有多个成人和儿童体外生命支持中心的大都市地区开发的合作框架，旨在为COVID-19等大流行期间ECMO使用的决策提供信息。它还解决了在灾难期间不继续提供ECMO的道德和实践方面。
Health systems confronting the coronavirus disease 2019 (COVID-19) pandemic must plan for surges in ICU demand and equitably distribute resources to maximize benefit for critically ill patients and the public during periods of resource scarcity. For example, morbidity and mortality could be mitigated by a proactive regional plan for the triage of mechanical ventilators. Extracorporeal membrane oxygenation (ECMO), a resource-intensive and potentially lifesaving modality in severe respiratory failure, has generally not been included in proactive disaster preparedness until recently. This paper explores underlying assumptions and triage principles that could guide the integration of ECMO resources into existing disaster planning. Drawing from a collaborative framework developed by one US metropolitan area with multiple adult and pediatric extracorporeal life support centers, this paper aims to inform decision-making around ECMO use during a pandemic such as COVID-19. It also addresses the ethical and practical aspects of not continuing to offer ECMO during a disaster.