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How Should ECMO Be Used Under Conditions of Severe Scarcity? A Population Study of Public Perception.
Han, Jason J; Shin, Max; Patrick, William L; Rao, Akhil; Olia, Salim E; Helmers, Mark R; Iyengar, Amit; Kelly, John J; Smood, Benjamin; Gutsche, Jacob T; Bermudez, Christian; Cevasco, Marisa.
  • Han JJ; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Shin M; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Patrick WL; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Rao A; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Olia SE; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Helmers MR; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Iyengar A; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Kelly JJ; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Smood B; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Gutsche JT; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Bermudez C; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.
  • Cevasco M; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA; Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA. Electronic address: Marisa.cevasco@pennmedicine.upenn.edu.
J Cardiothorac Vasc Anesth ; 36(6): 1662-1669, 2022 06.
Article in English | MEDLINE | ID: covidwho-1294521
ABSTRACT

OBJECTIVE:

To assess societal preferences regarding allocation of extracorporeal membrane oxygenation (ECMO) as a rescue option for select patients with coronavirus disease 2019 (COVID-19).

DESIGN:

Cross-sectional survey of a nationally representative sample.

SETTING:

Amazon Mechanical Turk platform.

PARTICIPANTS:

In total, responses from 1,041 members of Amazon Mechanical Turk crowd-sourcing platform were included. Participants were 37.9 ± 12.6 years old, generally white (65%), and college-educated (66.1%). Many reported working in a healthcare setting (22.5%) and having a friend or family member who was admitted to the hospital (43.8%) or died from COVID-19 (29.9%). MEASUREMENTS AND MAIN

RESULTS:

Although most reported an unwillingness to stay on ECMO for >one week without signs of recovery, participants were highly supportive of ECMO utilization as a life-preserving technique on a policy level. The majority (96.7%) advocated for continued use of ECMO to treat COVID patients during periods of resource scarcity but would prioritize those with highest likelihood of recovery (50%) followed by those who were sickest regardless of survival chances (31.7%). Patients >40 years old were more likely to prefer distributing ECMO on a first-come first-served basis (21.5% v 13.3%, p < 0.05).

CONCLUSION:

Even though participants expressed hesitation regarding ECMO in personal circumstances, they were uniformly in support of using ECMO to treat COVID patients at a policy level for others who might need it, even in the setting of severe scarcity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Humans / Middle aged Language: English Journal: J Cardiothorac Vasc Anesth Journal subject: Anesthesiology / Cardiology Year: 2022 Document Type: Article Affiliation country: J.jvca.2021.05.058

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Humans / Middle aged Language: English Journal: J Cardiothorac Vasc Anesth Journal subject: Anesthesiology / Cardiology Year: 2022 Document Type: Article Affiliation country: J.jvca.2021.05.058