Abstract:
: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.
journal_name
Chestjournal_title
Chestauthors
Prekker ME,Brunsvold ME,Bohman JK,Fischer G,Gram KL,Litell JM,Saavedra-Romero R,Hick JLdoi
10.1016/j.chest.2020.04.026subject
Has Abstractpub_date
2020-08-01 00:00:00pages
603-607issue
2eissn
0012-3692issn
1931-3543pii
S0012-3692(20)30769-8journal_volume
158pub_type
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