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Regional Planning for Extracorporeal Membrane Oxygenation Allocation During Coronavirus Disease 2019.
Prekker, Matthew E; Brunsvold, Melissa E; Bohman, J Kyle; Fischer, Gwenyth; Gram, Kendra L; Litell, John M; Saavedra-Romero, Ramiro; Hick, John L.
  • Prekker ME; Department of Medicine, Division of Pulmonary & Critical Care, Hennepin Healthcare and the University of Minnesota Medical School, Minneapolis, MN; Department of Emergency Medicine, Hennepin Healthcare and the University of Minnesota Medical School, Minneapolis, MN. Electronic address: Matthew.P
  • Brunsvold ME; Department of Surgery, University of Minnesota Medical School, Minneapolis, MN.
  • Bohman JK; Department of Anesthesiology, Mayo Clinic School of Medicine, Rochester, MN.
  • Fischer G; Department of Pediatrics, Division of Pediatric Critical Care, University of Minnesota Medical School, Minneapolis, MN.
  • Gram KL; Pediatric Critical Care, Children's Minnesota, Minneapolis, MN.
  • Litell JM; Department of Critical Care, Allina Health, Minneapolis, MN; Department of Emergency Medicine, Hennepin Healthcare and the University of Minnesota Medical School, Minneapolis, MN.
  • Saavedra-Romero R; Department of Critical Care, Allina Health, Minneapolis, MN; Department of Medicine, the University of Minnesota Medical School, Minneapolis, MN.
  • Hick JL; Department of Emergency Medicine, Hennepin Healthcare and the University of Minnesota Medical School, Minneapolis, MN.
Chest ; 158(2): 603-607, 2020 08.
Article in English | MEDLINE | ID: covidwho-683267
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Extracorporeal Membrane Oxygenation / Ventilators, Mechanical / Triage / Critical Illness / Coronavirus Infections / Pandemics / Betacoronavirus Limits: Humans Language: English Journal: Chest Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Extracorporeal Membrane Oxygenation / Ventilators, Mechanical / Triage / Critical Illness / Coronavirus Infections / Pandemics / Betacoronavirus Limits: Humans Language: English Journal: Chest Year: 2020 Document Type: Article