[Organ assist devices in the future : Limits and perspectives]

Area of Science:

• Critical Care Medicine
• Cardiovascular Surgery
• Respiratory Medicine

Background:

• Extracorporeal organ assist devices, including extracorporeal membrane oxygenation (ECMO), are increasingly utilized for severe respiratory failure and cardiogenic shock.
• Despite technical advancements, ECMO carries significant risks and the scientific evidence supporting its use is still limited.

Purpose of the Study:

• To highlight the challenges in selecting patients who will benefit most from ECMO.
• To emphasize the need for comprehensive patient evaluation, including underlying disease, comorbidities, and functional status, within an interdisciplinary team.
• To address the ethical considerations associated with ECMO therapy.

Main Methods:

• Review of current practices and challenges in ECMO patient selection.
• Emphasis on interdisciplinary team approach for comprehensive patient assessment.
• Discussion of organizational demands and ethical considerations.

Main Results:

• Patient selection for ECMO remains a significant challenge for intensivists and medical teams.
• Thorough evaluation of disease etiology, comorbidities, and patient's functional status is essential.
• Ethical challenges are inherent in complex ECMO treatments.

Conclusions:

• ECMO treatment requires careful patient selection and a multidisciplinary approach.
• Concentrating ECMO treatments in specialized, qualified centers is recommended due to complexity and organizational demands.
• Further comprehensive scientific analysis of ECMO treatment data is essential to improve patient outcomes.