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Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an

Kiran Shekar1, Jenelle Badulak2, Giles Peek3

  • 1From Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 1, 2020
PubMed

Insights

These guidelines offer recommendations for extracorporeal membrane oxygenation (ECMO) centers during the COVID-19 pandemic. They provide expert-based strategies for preparing and managing ECMO for critically ill patients.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Cardiopulmonary Support

Background:

  • The Coronavirus Disease 2019 (COVID-19) pandemic has placed unprecedented strain on healthcare systems globally.
  • Critically ill patients with severe respiratory or cardiac failure due to COVID-19 may require advanced life support such as extracorporeal membrane oxygenation (ECMO).
  • Existing extracorporeal membrane oxygenation (ECMO) centers require specific guidance to manage the surge in demand and unique challenges posed by COVID-19.

Purpose of the Study:

  • To provide evidence-based recommendations for the provision and clinical management of ECMO in the context of the COVID-19 pandemic.
  • To assist existing ECMO centers in preparing and planning for the care of COVID-19 patients requiring extracorporeal support.
  • To offer a framework for interdisciplinary ECMO providers worldwide to standardize care during the pandemic.

Main Methods:

  • Development of guidelines by a global, interdisciplinary team of ECMO providers.
  • Recommendations based on a synthesis of available evidence, existing best practice guidelines, ethical principles, and expert opinion.
  • Establishment of a living document format to allow for regular updates as new information emerges.

Main Results:

  • The guidelines offer a comprehensive framework for ECMO centers to prepare for and manage COVID-19 patients.
  • Recommendations cover various aspects of ECMO provision, including patient selection, resource allocation, and ethical considerations.
  • The document emphasizes the importance of adapting existing ECMO protocols to the specific needs of COVID-19 patients.

Conclusions:

  • These ELSO guidelines provide essential, expert-driven recommendations for ECMO centers navigating the COVID-19 pandemic.
  • The guidelines aim to enhance the preparedness and clinical management of ECMO for critically ill patients with COVID-19.
  • Adherence to these recommendations can strengthen ECMO service delivery and improve patient outcomes during the pandemic.

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