Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure –A clinical practice Guideline Level 3

• DOI: 10.1002/ehf2.13718
• Publication Date: 2021-11-23T03:12:23Z
• Authors: Alexander Assmann; Andreas Beckmann; Christof Schmid; Karl Werdan; Guido Michels; Oliver Miera; Florian Schmidt; Stefan Klotz; Christoph Starck; Kevin Pilarczyk; Ardawan Rastan; Marion Burckhardt; Monika Nothacker; Ralf Muellenbach; York Zausig; Nils Haake; Heinrich Groesdonk; Markus Ferrari; Michael Buerke; Marcus Hennersdorf; Mark Rosenberg; Thomas Schaible; Harald Köditz; Stefan Kluge; Uwe Janssens; Matthias Lubnow; Andreas Flemmer; Susanne Herber‐Jonat; Lucas Wessel; Dirk Buchwald; Sven Maier; Lars Krüger; Andreas Fründ; Rolf Jaksties; Stefan Fischer; Karsten Wiebe; Christiane S. Hartog; Omer Dzemali; Daniel Zimpfer; Elfriede Ruttmann...; Christian Schlensak; Malte Kelm; Stephan Ensminger; Udo Boeken
• Keywords: ddc:610; Extracorporeal Circulation; 610 Medizin; 610; Shock; Extracorporeal life support (ECLS); Original Articles; Guideline; Recommendation; Extracorporeal membrane oxygenation (ECMO); 3. Good health; 03 medical and health sciences; Extracorporeal Membrane Oxygenation; 0302 clinical medicine; REFRACTORY CARDIOGENIC-SHOCK; MEMBRANE-OXYGENATION; LIFE-SUPPORT; POSITION PAPER; ADULT PATIENTS; CARDIOPULMONARY-RESUSCITATION; NEUROLOGIC COMPLICATIONS; SURVIVAL; ORGANIZATION; ARREST; Extracorporeal life support (ECLS); Extracorporeal membrane oxygenation (ECMO); Cardiac and circulatory failure; Guideline; Recommendation; RC666-701; Germany; Practice Guidelines as Topic; Diseases of the circulatory (Cardiovascular) system; Humans; Cardiac and circulatory failure

AbstractAims Worldwide applications of extracorporeal circulation for mechanical support in cardiac and circulatory failure, which are referred to as extracorporeal life support (ECLS) or veno‐arterial extracorporeal membrane oxygenation (va‐ECMO), have dramatically increased over the past decade. In spite of the expanding use and the immense medical as well as socio‐economic impact of this therapeutic approach, there has been a lack of interdisciplinary recommendations considering the best available evidence for ECLS treatment.Methods and Results In a multiprofessional, interdisciplinary scientific effort of all scientific societies involved in the treatment of patients with acute cardiac and circulatory failure, the first evidence‐ and expert consensus‐based guideline (level S3) on ECLS/ECMO therapy was developed in a structured approach under regulations of the AWMF (Association of the Scientific Medical Societies in Germany) and under use of GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. This article presents all recommendations created by the expert panel, addressing a multitude of aspects for ECLS initiation, continuation, weaning and aftercare as well as structural and personnel requirements.Conclusions This first evidence‐ and expert consensus‐based guideline (level S3) on ECLS/ECMO therapy should be used to apply the best available care nationwide. Beyond clinical practice advice, remaining important research aspects for future scientific efforts are formulated.