Regional Planning for Extracorporeal Membrane Oxygenation Allocation During Coronavirus Disease 2019
Autor: | Kendra L. Gram, John M. Litell, J. Kyle Bohman, John L. Hick, Gwenyth Fischer, Melissa E. Brunsvold, Matthew E. Prekker, Ramiro Saavedra-Romero |
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Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
Coronavirus disease 2019 (COVID-19) Critical Illness medicine.medical_treatment Pneumonia Viral Global Health Critical Care and Intensive Care Medicine Extracorporeal Betacoronavirus 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Regional planning Pandemic Global health medicine Extracorporeal membrane oxygenation Humans 030212 general & internal medicine Pandemics Ventilators Mechanical SARS-CoV-2 business.industry COVID-19 medicine.disease Triage 030228 respiratory system Life support Medical emergency Coronavirus Infections Cardiology and Cardiovascular Medicine business |
Zdroj: | Chest |
ISSN: | 0012-3692 |
DOI: | 10.1016/j.chest.2020.04.026 |
Popis: | 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 life-saving 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. |
Databáze: | OpenAIRE |
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