• J. Pediatr. Surg. · Dec 2020

    Review

    Allocation of resources and development of guidelines for extracorporeal membrane oxygenation (ECMO): Experience from a pediatric center in the epicenter of the COVID-19 pandemic.

    • Claire Gerall, Eva W Cheung, Rafael Klein-Cloud, Erica Kreines, Michael Brewer, and William Middlesworth.
    • Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Hospital, 3959 Broadway, CHN2, New York, NY 10032. Electronic address: cg3173@cumc.columbia.edu.
    • J. Pediatr. Surg. 2020 Dec 1; 55 (12): 2548-2554.

    AbstractThe rapid spread of coronavirus disease 2019 (COVID-19) has exceeded the standard capacity of many hospital systems and led to an unprecedented scarcity of resources, including the already limited resource of extracorporeal membrane oxygenation (ECMO). With the large amount of critically ill patients and the highly contagious nature of the virus, significant consideration of ECMO candidacy is crucial for both appropriate allocation of resources as well as ensuring protection of health care personnel. As a leading pediatric ECMO program in the epicenter of the pandemic, we established new protocols and guidelines in order to continue caring for our pediatric patients while accepting adult patients to lessen the burden of our hospital system which was above capacity. This article describes our changes in consultation, cannulation, and daily care of COVID-19 positive patients requiring ECMO as well as discusses strategies for ensuring safety of our ECMO healthcare personnel and optimal allocation of resources. LEVEL OF EVIDENCE: Level V.Copyright © 2020 Elsevier Inc. All rights reserved.

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