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Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients.
Am J Respir Crit Care Med 2014; 190(5):488-96AJ

Abstract

The use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure (ARF) in adults is growing rapidly given recent advances in technology, even though there is controversy regarding the evidence justifying its use. Because ECMO is a complex, high-risk, and costly modality, at present it should be conducted in centers with sufficient experience, volume, and expertise to ensure it is used safely. This position paper represents the consensus opinion of an international group of physicians and associated health-care workers who have expertise in therapeutic modalities used in the treatment of patients with severe ARF, with a focus on ECMO. The aim of this paper is to provide physicians, ECMO center directors and coordinators, hospital directors, health-care organizations, and regional, national, and international policy makers a description of the optimal approach to organizing ECMO programs for ARF in adult patients. Importantly, this will help ensure that ECMO is delivered safely and proficiently, such that future observational and randomized clinical trials assessing this technique may be performed by experienced centers under homogeneous and optimal conditions. Given the need for further evidence, we encourage restraint in the widespread use of ECMO until we have a better appreciation for both the potential clinical applications and the optimal techniques for performing ECMO.

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    Authors+Show Affiliations

    Combes A
    1 Institute of Cardiometabolism and Nutrition, Groupe Hospitalier Pitié-Salpêtrière, Pierre Marie Curie University, Paris, France.
    Brodie D
    No affiliation info available
    Bartlett R
    No affiliation info available
    Brochard L
    No affiliation info available
    Brower R
    No affiliation info available
    Conrad S
    No affiliation info available
    De Backer D
    No affiliation info available
    Fan E
    No affiliation info available
    Ferguson N
    No affiliation info available
    Fortenberry J
    No affiliation info available
    Fraser J
    No affiliation info available
    Gattinoni L
    No affiliation info available
    Lynch W
    No affiliation info available
    MacLaren G
    No affiliation info available
    Mercat A
    No affiliation info available
    Mueller T
    No affiliation info available
    Ogino M
    No affiliation info available
    Peek G
    No affiliation info available
    Pellegrino V
    No affiliation info available
    Pesenti A
    No affiliation info available
    Ranieri M
    No affiliation info available
    Slutsky A
    No affiliation info available
    Vuylsteke A
    No affiliation info available
    International ECMO Network (ECMONet)
    No affiliation info available

    MeSH

    AdultAmbulancesBiomedical ResearchCritical CareExtracorporeal Membrane OxygenationHumansProgram DevelopmentProgram EvaluationQuality Assurance, Health CareReferral and ConsultationRespiratory Distress Syndrome, AdultTertiary Care CentersTransportation of Patients

    Pub Type(s)

    Consensus Development Conference
    Journal Article
    Practice Guideline

    Language

    eng

    PubMed ID

    25062496

    Citation

    Combes, Alain, et al. "Position Paper for the Organization of Extracorporeal Membrane Oxygenation Programs for Acute Respiratory Failure in Adult Patients." American Journal of Respiratory and Critical Care Medicine, vol. 190, no. 5, 2014, pp. 488-96.
    Combes A, Brodie D, Bartlett R, et al. Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med. 2014;190(5):488-96.
    Combes, A., Brodie, D., Bartlett, R., Brochard, L., Brower, R., Conrad, S., ... Vuylsteke, A. (2014). Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. American Journal of Respiratory and Critical Care Medicine, 190(5), pp. 488-96. doi:10.1164/rccm.201404-0630CP.
    Combes A, et al. Position Paper for the Organization of Extracorporeal Membrane Oxygenation Programs for Acute Respiratory Failure in Adult Patients. Am J Respir Crit Care Med. 2014 Sep 1;190(5):488-96. PubMed PMID: 25062496.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. AU - Combes,Alain, AU - Brodie,Daniel, AU - Bartlett,Robert, AU - Brochard,Laurent, AU - Brower,Roy, AU - Conrad,Steve, AU - De Backer,Daniel, AU - Fan,Eddy, AU - Ferguson,Niall, AU - Fortenberry,James, AU - Fraser,John, AU - Gattinoni,Luciano, AU - Lynch,William, AU - MacLaren,Graeme, AU - Mercat,Alain, AU - Mueller,Thomas, AU - Ogino,Mark, AU - Peek,Giles, AU - Pellegrino,Vince, AU - Pesenti,Antonio, AU - Ranieri,Marco, AU - Slutsky,Arthur, AU - Vuylsteke,Alain, AU - ,, PY - 2014/7/26/entrez PY - 2014/7/26/pubmed PY - 2014/10/29/medline KW - acute respiratory distress syndrome KW - critical care networks KW - extracorporeal membrane oxygenation KW - hospital organization KW - position article SP - 488 EP - 96 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 190 IS - 5 N2 - The use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure (ARF) in adults is growing rapidly given recent advances in technology, even though there is controversy regarding the evidence justifying its use. Because ECMO is a complex, high-risk, and costly modality, at present it should be conducted in centers with sufficient experience, volume, and expertise to ensure it is used safely. This position paper represents the consensus opinion of an international group of physicians and associated health-care workers who have expertise in therapeutic modalities used in the treatment of patients with severe ARF, with a focus on ECMO. The aim of this paper is to provide physicians, ECMO center directors and coordinators, hospital directors, health-care organizations, and regional, national, and international policy makers a description of the optimal approach to organizing ECMO programs for ARF in adult patients. Importantly, this will help ensure that ECMO is delivered safely and proficiently, such that future observational and randomized clinical trials assessing this technique may be performed by experienced centers under homogeneous and optimal conditions. Given the need for further evidence, we encourage restraint in the widespread use of ECMO until we have a better appreciation for both the potential clinical applications and the optimal techniques for performing ECMO. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/25062496/full_citation L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.201404-0630CP?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -