• Matthew E Prekker, Melissa E Brunsvold, J Kyle Bohman, Gwenyth Fischer, Kendra L Gram, John M Litell, Ramiro Saavedra-Romero, and John L Hick.
• Department of Medicine, Division of Pulmonary & Critical Care, Hennepin Healthcare and the University of Minnesota Medical School, Minneapolis, MN; Department of Emergency Medicine, Hennepin Healthcare and the University of Minnesota Medical School, Minneapolis, MN. Electronic address: Matthew.Prekker@hcmed.org.
• Chest. 2020 Aug 1; 158 (2): 603-607.

AbstractHealth systems confronting the coronavirus disease 2019 (COVID-19) pandemic must plan for surges in ICU demand and equitably distribute resources to maximize benefit for critically ill patients and the public during periods of resource scarcity. For example, morbidity and mortality could be mitigated by a proactive regional plan for the triage of mechanical ventilators. Extracorporeal membrane oxygenation (ECMO), a resource-intensive and potentially life-saving modality in severe respiratory failure, has generally not been included in proactive disaster preparedness until recently. This paper explores underlying assumptions and triage principles that could guide the integration of ECMO resources into existing disaster planning. Drawing from a collaborative framework developed by one US metropolitan area with multiple adult and pediatric extracorporeal life support centers, this paper aims to inform decision-making around ECMO use during a pandemic such as COVID-19. It also addresses the ethical and practical aspects of not continuing to offer ECMO during a disaster.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

22 keywords...

hide…