Abstract:
OBJECTIVES:To define the role of the intensivist in the initiation and management of patients on extracorporeal membrane oxygenation. DESIGN:Retrospective review of the literature and expert consensus. SETTING:Series of in-person meetings, conference calls, and emails from January 2018 to March 2019. SUBJECTS:A multidisciplinary, expert Task Force was appointed and assembled by the Society of Critical Care Medicine and the Extracorporeal Life Support Organization. Experts were identified by their respective societies based on reputation, experience, and contribution to the field. INTERVENTIONS:A MEDLINE search was performed and all members of the Task Force reviewed relevant references, summarizing high-quality evidence when available. Consensus was obtained using a modified Delphi process, with agreement determined by voting using the RAND/UCLA scale, with score ranging from 1 to 9. MEASUREMENTS AND MAIN RESULTS:The Task Force developed 18 strong and five weak recommendations in five topic areas of extracorporeal membrane oxygenation initiation and management. These recommendations were organized into five areas related to the care of patients on extracorporeal membrane oxygenation: patient selection, management, mitigation of complications, coordination of multidisciplinary care, and communication with surrogate decision-makers. A common theme of the recommendations is extracorporeal membrane oxygenation is best performed by a multidisciplinary team, which intensivists are positioned to engage and lead. CONCLUSIONS:The role of the intensivist in the care of patients on extracorporeal membrane oxygenation continues to evolve and grow, especially when knowledge and familiarity of the issues surrounding extracorporeal membrane oxygenation selection, cannulation, and management are applied.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
DellaVolpe J,Barbaro RP,Cannon JW,Fan E,Greene WR,Gunnerson KJ,Napolitano LM,Ovil A,Pamplin JC,Schmidt M,Sorce LR,Brodie Ddoi
10.1097/CCM.0000000000004330subject
Has Abstractpub_date
2020-06-01 00:00:00pages
838-846issue
6eissn
0090-3493issn
1530-0293journal_volume
48pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study is to: 1) describe a newly mechanism of blood flow to the brain during cardiopulmonary resuscitation using the impedance threshold device in a piglet model of cardiac arrest, and 2) describe the survival benefits in humans of applying all of the highly recommended changes in the 2005...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/ccm.0b013e31818a7e56
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between nitric oxide production, endotoxemia, and hemodynamic alterations in human septic shock. DESIGN:Prospective study. SETTING:A 32-bed intensive care unit in a university referral hospital. PATIENTS:Two groups of septic patients with shock (n = 13) or without shock (n =...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199502000-00009
更新日期:1995-02-01 00:00:00
abstract::A patient with brainstem infarction met the clinical criteria for brain death but had persistent EEG activity, complicating our decision to withdraw life support. We evaluated cerebral blood flow with xenon-enhanced computed tomography (Xe/CT), which documented the absence of posterior circulation flow and persistent,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00014
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVES:ICU admission delays can negatively affect patient outcomes, but emergency department volume and boarding times may also affect these decisions and associated patient outcomes. We sought to investigate the effect of emergency department and ICU capacity strain on ICU admission decisions and to examine the ef...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002993
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the clinical utility of right ventricular end-diastolic volume index (RVEDVI) and pulmonary artery occlusion pressure (PAOP) as measures of preload status in patients with acute respiratory failure receiving treatment with positive end-expiratory pressure. DESIGN:Prospective, cohort study. SETTI...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199811000-00017
更新日期:1998-11-01 00:00:00
abstract::In order to examine the prognostic value of pulmonary arterial hypertension (PAH) in patients with moderate and severe acute respiratory failure (ARF), 225 patients with ARF who had been treated with mechanical ventilation and admitted to our ICU during a 3-yr period (January, 1983 to January, 1986) were prospectively...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198906000-00007
更新日期:1989-06-01 00:00:00
abstract::End tidal CO2 tension (PetCO2) and transcutaneous CO2 tension (PtcCO2) were compared with arterial CO2 (PaCO2) before and after withdrawal of mechanical ventilation in 20 patients predisposed to hypercarbia. With stable PaCO2 during mechanical ventilation, the correlation coefficient (r) between PaCO2 and PetCO2 was ....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198708000-00011
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Septic shock represents the major cause of infection-associated mortality in the intensive care unit. The possibility that combination antibiotic therapy of bacterial septic shock improves outcome is controversial. Current guidelines do not recommend combination therapy except for the express purpose of broa...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181eb3ccd
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:The role of nitric oxide in mediating the early phase of hypotension and cardiovascular hyporeactivity in sepsis, and the cellular sources of inducible nitric oxide synthase expression under in vivo conditions, remain unclear. The objective of this study was to elucidate the time course and cellular location...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00022
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To determine whether the energy expenditure of mechanically ventilated multiple trauma patients correlates with the severity of injury and illness indices before important systemic infection has complicated the clinical course, and to compare the energy expenditure with the energy expenditure expected from th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00013
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVES:To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN:Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regressio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002753
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:To assess trends in the use of extracorporeal membrane oxygenation for poisoning in the United States. DESIGN:Retrospective cohort study. SETTING:The National Poison Data System, the databased owned and managed by the American Association of Poison Control Centers, the organization that supports and accred...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004401
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To examine the association between the performance of a tracheostomy and intensive care unit and postintensive care unit mortality, controlling for treatment selection bias and confounding variables. DESIGN:Prospective, observational, cohort study. SETTING:Twelve French medical or surgical intensive care un...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000251134.96055.A6
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Cardiogenic shock remains an important therapeutic challenge, with high in-hospital mortality rates. Mechanical circulatory support may be beneficial in these patients. Since the efficacy of the intra-aortic balloon pump seems limited, new percutaneously placed mechanical left ventricular support devices, suc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31821e89b5
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Most studies have assessed conflict between clinicians and surrogate decision makers in ICUs from only clinicians' perspectives. It is unknown if surrogates' perceptions differ from clinicians'. We sought to determine the degree of agreement between physicians and surrogates about conflict and to identify pre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a27598
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To evaluate a new technique for pressure-volume curve tracing. DESIGN:Prospective experimental study. SETTING:Animal research laboratory. SUBJECTS:Six anesthetized rats. INTERVENTIONS:Two pressure-volume curves were obtained by means of the super-syringe method (gold standard) and the continuous positive ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000090003.87219.AA
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To characterize the endothelium-dependent and endothelium-independent components of abnormal pulmonary vascular tone in canine oleic acid lung injury. DESIGN:Prospective, interventional study. SETTING:University laboratory. SUBJECTS:Twenty anesthetized mongrel dogs. INTERVENTIONS:Right heart catheterizati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200207000-00028
更新日期:2002-07-01 00:00:00
abstract::A difference between potassium concentrations in arterial plasma and venous serum was evaluated. The difference was 0.5 mM/litre, with a range of 0.1 to 1.1 mM/liter. Multiple factors operating primarily upon the venous sample are responsible for this difference. The value for arterial plasma potassium is stable and p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197809000-00008
更新日期:1978-09-01 00:00:00
abstract:OBJECTIVES:The impact of recruitment maneuvers on gas exchange, hemodynamics, alveolar recruitment, and hyperinflation is highly variable among patients with acute respiratory distress syndrome. The objective was to determine whether differences in lung morphology, defined as differences in the pulmonary distribution o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181d451ec
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for nosocomial pneumonia in critically ill trauma patients. DESIGN:Prospective cohort study. SETTING:The trauma intensive care unit (ICU) of a 1500-bed tertiary-care hospital. PATIENTS:All critically ill trauma patients (n = 103) admitted consecutively between November 1995 and Oc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200102000-00015
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:To compare the incidence of withdrawal or withholding of life support (WD/WHLS), and to identify similarities and differences in the process of the withdrawal of life support (WDLS) between teaching and community hospitals' intensive care units (ICUs). DESIGN:Prospective cohort study, with some data obtaine...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199802000-00018
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. DESIGN:A single-group descriptive longitudinal cor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000934
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:The objective of the present study was to determine whether selective inflammatory cytokine concentrations within cerebrospinal fluid are useful markers for the differential diagnosis of aseptic and bacterial meningitis within neurosurgical patients. DESIGN:Prospective, open-label, observational, cohort stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001188
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To review current knowledge about the impact of prolonged mechanical ventilation on diaphragmatic function and biology. MEASUREMENTS:Systematic literature review. CONCLUSIONS:Prolonged mechanical ventilation can promote diaphragmatic atrophy and contractile dysfunction. As few as 18 hrs of mechanical ventil...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181b6e760
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:To address the association between the 2003 heat wave in Paris (France) and the occurrence of out-of-hospital cardiac arrest. DESIGN:: An analysis of the interventions of the medical mobile intensive care units of the City of Paris for out-of-hospital cardiac arrest and prehospital myocardial infarctions, w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b0868f
更新日期:2009-12-01 00:00:00
abstract::The effects of the Trendelenburg (TREND) position and passive straight leg raising (PLR) on cardiopulmonary performance in 18 anesthetized patients undergoing myocardial revascularization were studied with a two-dimensional transesophageal echocardiography probe and a thermodilution right ventricular ejection fraction...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198904000-00003
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:To assess clinician perceptions of a machine learning-based early warning system to predict severe sepsis and septic shock (Early Warning System 2.0). DESIGN:Prospective observational study. SETTING:Tertiary teaching hospital in Philadelphia, PA. PATIENTS:Non-ICU admissions November-December 2016. INTERVE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003803
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To investigate whether a redistribution of blood flow from the mucosa to the muscular layer of the intestinal wall contributes to the observed increased arterial-mucosal Pco2 gradient and the decreased mucosal tonometric pH during endotoxic shock. DESIGN:A prospective, controlled, animal study. SETTING:Anim...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199608000-00013
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVES:Cognitive deficits after traumatic brain injury are a leading cause of disability worldwide, yet no effective pharmacologic treatments exist to improve cognition. Traumatic brain injury increases proinflammatory cytokines, which trigger excess function of α5 subunit-containing γ-aminobutyric acid type A rece...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004161
更新日期:2020-04-01 00:00:00
abstract::Previously, we determined that a colloid concentration of about 3% was optimal for resuscitation of lethal ischemic intestinal shock model in rats. Maximal volumes of lactated Ringer's solution (RL) alone only expanded plasma volume (PV) to 80% of preshock level, while increasing volumes of 3% albumin (ALB) in RL line...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199001000-00014
更新日期:1990-01-01 00:00:00