Perception of prolonged extracorporeal membrane oxygenation in Europe: an EuroELSO survey

Philipp M. Lepper, Nicholas A. Barrett, Justyna Swol, Roberto Lorusso, Matteo Di Nardo, Mirko Belliato, Jan Bělohlávek, Lars Mikael Broman

Research output: Contribution to journalArticlepeer-review

Abstract

The substantial increase in the number of patients receiving extracorporeal membrane oxygenation over the last decade has led to an evolution of indications and an expansion into wider patient groups. One of the unanticipated benefits of the increase in extracorporeal membrane oxygenation has been a change in the understanding of the natural history of many respiratory diseases. Development in technology and materials, reduced extracorporeal membrane oxygenation–specific complications, and improvement of critical care, in general, have facilitated longer extracorporeal membrane oxygenation runs, and the definition of prolonged extracorporeal membrane oxygenation was recently expanded to continuous support for more than 28 days. This survey aimed to describe European ECMO centers’ perception and arbitrary definition of prolonged extracorporeal membrane oxygenation, patient management, and futility. Of 94 center responses, 37% regarded 14-21 days, 30% 21-28 days, and 28% >28 days as prolonged treatment. Bridge to recovery (64%) or to transplantation (20%) was the most common causes. Awake, and ambulation while on extracorporeal membrane oxygenation was reported from 34% of the centers. In case of perceived futility, decision to withdraw was taken in 65% of the centers in agreement between profession and family and in 30% by profession only. One-fourth of the centers did not discontinue support. Large differences prevail among European ECMO centers concerning local perception and patient management in prolonged extracorporeal membrane oxygenation.

Original languageEnglish
Pages (from-to)81-85
Number of pages5
JournalPerfusion (United Kingdom)
Volume35
Issue number1_suppl
DOIs
Publication statusPublished - May 1 2020

Keywords

  • Europe
  • extracorporeal membrane oxygenation
  • futility
  • long-term
  • prolonged

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

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