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. 2020 Jun;48(6):838-846.
doi: 10.1097/CCM.0000000000004330.

Joint Society of Critical Care Medicine-Extracorporeal Life Support Organization Task Force Position Paper on the Role of the Intensivist in the Initiation and Management of Extracorporeal Membrane Oxygenation

Jeffrey DellaVolpe  1 , Ryan P Barbaro  2 , Jeremy W Cannon  3 , Eddy Fan  4 , Wendy R Greene  5 , Kyle J Gunnerson  6 , Lena M Napolitano  2 , Ace Ovil  7 , Jeremy C Pamplin  8 , Matthieu Schmidt  9 , Lauren R Sorce  10 , Daniel Brodie  11
Affiliations

Joint Society of Critical Care Medicine-Extracorporeal Life Support Organization Task Force Position Paper on the Role of the Intensivist in the Initiation and Management of Extracorporeal Membrane Oxygenation

Jeffrey DellaVolpe et al. Crit Care Med. 2020 Jun.

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.

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Conflict of interest statement

CONFLICTS OF INTEREST

Ryan P. Barbaro, MD, MS: Extracorporeal Life Support Organization Steering Committee Member as the ELSO Registry Chair

Daniel Brodie, MD: ELSO Board of Directors and Steering Committee; Trial Steering Committee, VENT-AVOID trial, ALung Technologies; previously Medical Advisory Board (MAB), ALung Technologies; currently, MAB for Baxter, BREETHE, Hemovent and Novalung

Jeremy W. Cannon, MD: simulation equipment provided to Penn Medicine Sim Center by PryTime Medical

Eddy Fan, MD, PhD: personal fees from MC3 Cardiopulmonary and ALung Technologies outside the submitted work; a New Investigator Award from the Canadian Institutes of Health Research; Chair-elect of ATS Critical Care Program Committee

Lena M. Napolitano, MD, MCCM: American College of Surgeons committee, American Association for Surgery of Trauma Committees, American Board of Surgery Director

Matthieu Schmidt, MD, PhD: receiving personal fees from Getinge, Xenios and Drager

References

    1. Conrad SA, Broman LM, Taccone FS, Lorusso R, Malfertheiner MV, Pappalardo F, Di Nardo M, Belliato M, Grazioli L, Barbaro RP et al. : The Extracorporeal Life Support Organization Maastricht Treaty for Nomenclature in Extracorporeal Life Support. A Position Paper of the Extracorporeal Life Support Organization. Am J Respir Crit Care Med 2018. - PMC - PubMed
    1. Thiagarajan RR, Barbaro RP, Rycus PT, McMullan DM, Conrad SA, Fortenberry JD, Paden ML, centers Em: Extracorporeal Life Support Organization Registry International Report 2016. ASAIO J 2017, 63(1):60–67. - PubMed
    1. Sauer CM, Yuh DD, Bonde P: Extracorporeal membrane oxygenation use has increased by 433% in adults in the United States from 2006 to 2011. Asaio j 2015, 61(1):31–36. - PubMed
    1. Brodie D, Bacchetta M: Extracorporeal membrane oxygenation for ARDS in adults. N Engl J Med 2011, 365(20):1905–1914. - PubMed
    1. Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, Olsson KM, Greer M, Sommer W, Welte T et al. : Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. Am J Respir Crit Care Med 2012, 185(7):763–768. - PubMed

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