Venoarterial ECMO for Adults JACC Scientific Expert Panel

被引:316
作者
Guglin, Maya [1 ]
Zucker, Mark J. [2 ]
Bazan, Vanessa M. [3 ]
Bozkurt, Biykem [4 ,5 ]
El Banayosy, Aly [6 ]
Estep, Jerry D. [7 ]
Gurley, John [1 ]
Nelson, Karl [6 ]
Malyala, Rajasekhar [8 ]
Panjrath, Gurusher S. [9 ]
Zwischenberger, Joseph B. [8 ]
Pinney, Sean P. [10 ]
机构
[1] Univ Kentucky, Gill Heart Inst, Lexington, KY USA
[2] Rutgers State Univ, New Jersey Med Sch, Cardiothorac Transplantat Programs, Newark Beth Israel Med Ctr, Newark, NJ USA
[3] Univ Kentucky, Lexington, KY USA
[4] Baylor Coll Med, Michael E DeBakey VA Med Ctr, Houston, TX 77030 USA
[5] Baylor Coll Med, Dept Med, Sect Cardiol, Houston, TX 77030 USA
[6] INTEGRIS Baptist Med Ctr, Acute Circulatory Support & Adv Crit Care, Oklahoma City, OK USA
[7] Cleveland Clin Fdn, Sect Heart Failure & Transplantat, 9500 Euclid Ave, Cleveland, OH 44195 USA
[8] Univ Kentucky, Dept Surg, Lexington, KY USA
[9] George Washington Univ, Dept Med, Div Cardiol, Washington, DC USA
[10] Icahn Sch Med Mt Sinai, Div Cardiol, New York, NY 10029 USA
关键词
cardiac arrest; cardiogenic shock; ECLS; EXTRACORPOREAL MEMBRANE-OXYGENATION; HOSPITAL CARDIAC-ARREST; PERCUTANEOUS CARDIOPULMONARY SUPPORT; ACUTE FULMINANT MYOCARDITIS; CARDIOGENIC-SHOCK PATIENTS; ACUTE RESPIRATORY-FAILURE; ACUTE LUNG INJURY; LIFE-SUPPORT; CIRCULATORY SUPPORT; RESUSCITATION EFFORTS;
D O I
10.1016/j.jacc.2018.11.038
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Venoarterial extracorporeal membrane oxygenation (ECMO) is a rescue therapy that can stabilize patients with hemodynamic compromise, with or without respiratory failure, for days or weeks. In cardiology, the main indications for ECMO include cardiac arrest, cardiogenic shock, post-cardiotomy shock, refractory ventricular tachycardia, and acute management of complications of invasive procedures. The fundamental premise underlying ECMO is that it is a bridge-to recovery, to a more durable bridge, to definitive treatment, or to decision. As a very resource-and effort-intensive intervention, ECMO should not be used on unsalvageable patients. As the use of this technology continues to evolve rapidly, it is important to understand the indications and contraindications; the logistics of ECMO initiation, management, and weaning; the general infrastructure of the program (including the challenges associated with transferring patients supported by ECMO); and ethical considerations, areas of uncertainty, and future directions. (c) 2019 by the American College of Cardiology Foundation.
引用
收藏
页码:698 / 716
页数:19
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