ESC Heart Failure (Feb 2022)
Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure –A clinical practice Guideline Level 3
- 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‐Ulmer,
- Christian Schlensak,
- Malte Kelm,
- Stephan Ensminger,
- Udo Boeken
Affiliations
- Alexander Assmann
- Department of Cardiac Surgery Heinrich Heine University, Medical Faculty Moorenstr. 5 Düsseldorf 40225 Germany
- Andreas Beckmann
- German Society for Thoracic and Cardiovascular Surgery Langenbeck‐Virchow‐Haus Berlin Germany
- Christof Schmid
- Department of Cardiothoracic Surgery University Medical Center Regensburg Regensburg Germany
- Karl Werdan
- Clinic for Internal Medicine III University Hospital Halle (Saale), Martin‐Luther University Halle‐Wittenberg Halle Germany
- Guido Michels
- Department of Acute and Emergency Care St Antonius Hospital Eschweiler Eschweiler Germany
- Oliver Miera
- Department of Congenital Heart Disease‐Pediatric Cardiology German Heart Center Berlin Berlin Germany
- Florian Schmidt
- Department of Pediatric Cardiology and Intensive Care Medicine Medical School Hannover Hannover Germany
- Stefan Klotz
- Department of Cardiac Surgery Segeberger Kliniken Bad Segeberg Germany
- Christoph Starck
- Department of Cardiothoracic and Vascular Surgery German Heart Centre Berlin Germany
- Kevin Pilarczyk
- Department for Intensive Care Medicine Imland Hospital Rendsburg Rendsburg Schleswig‐Holstein Germany
- Ardawan Rastan
- Department of Cardiac and Vascular Thoracic Surgery Philipps‐University Hospital Marburg Marburg Germany
- Marion Burckhardt
- Department of Health Sciences and Management Baden‐Wuerttemberg Cooperative State University (DHBW) Stuttgart Germany
- Monika Nothacker
- Institute for Medical Knowledge Management, Association of the Scientific Medical Societies (AWMF) Universität Marburg Marburg Germany
- Ralf Muellenbach
- Department of Anaesthesiology and Critical Care Medicine Campus Kassel of the University of Southampton Kassel Germany
- York Zausig
- Department of Anesthesiology and Operative Intensive Care Medicine Aschaffenburg‐Alzenau Hospital Aschaffenburg Bavaria Germany
- Nils Haake
- Department for Intensive Care Medicine Imland Hospital Rendsburg Rendsburg Schleswig‐Holstein Germany
- Heinrich Groesdonk
- Department of Intensive Care Medicine Helios Clinic Erfurt Erfurt Germany
- Markus Ferrari
- HSK, Clinic of Internal Medicine I, Helios‐Kliniken Wiesbaden Germany
- Michael Buerke
- Department of Cardiology, Angiology and Internal Intensive Care Medicine St. Marienkrankenhaus Siegen Siegen Germany
- Marcus Hennersdorf
- Department of Cardiology, Pneumology, Angiology and Internal Intensive Care Medicine SLK‐Kliniken Heilbronn Heilbronn Germany
- Mark Rosenberg
- Klinikum Aschaffenburg‐Alzenau, Medizinische Klinik 1 Aschaffenburg Germany
- Thomas Schaible
- Department of Neonatology University Children's Hospital Mannheim, University of Heidelberg Mannheim Germany
- Harald Köditz
- Medical University Children's Hospital Hannover Germany
- Stefan Kluge
- Klinik für Intensivmedizin Universitätsklinikum Hamburg‐Eppendorf Hamburg Germany
- Uwe Janssens
- Medical Clinic and Medical Intensive Care Medicine St Antonius Hospital Eschweiler Germany
- Matthias Lubnow
- Department of Internal Medicine II University Hospital Regensburg Regensburg Germany
- Andreas Flemmer
- Division of Neonatology Dr. v. Hauner Children's Hospital and Perinatal Center Munich ‐ Grosshadern, LMU Munich Munich Germany
- Susanne Herber‐Jonat
- Division of Neonatology Dr. v. Hauner Children's Hospital and Perinatal Center Munich ‐ Grosshader, LMU Munich Munich Germany
- Lucas Wessel
- Department of Pediatric Surgery, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
- Dirk Buchwald
- Department of Cardiothoracic Surgery University Hospital Bergmannsheil, Ruhr‐University Bochum Germany
- Sven Maier
- Department of Cardiovascular Surgery Heart Center Freiburg University Freiburg Germany
- Lars Krüger
- Division of Thoracic and Cardiovascular Surgery, Heart‐ and Diabetescentre NRW Ruhr‐University Bochum Germany
- Andreas Fründ
- Department of Physiotherapy, Heart‐ and Diabetescentre NRW Ruhr‐University Bochum Germany
- Rolf Jaksties
- German Heart Foundation Germany
- Stefan Fischer
- Department of Thoracic Surgery and Lung Support Ibbenbueren General Hospital Ibbenbueren Germany
- Karsten Wiebe
- Department of Cardiothoracic Surgery Münster University Hospital Münster Germany
- Christiane S. Hartog
- Department of Anesthesiology and Operative Intensive Care Medicine Charité Universitätsmedizin Berlin, and Klinik Bavaria Kreischa Germany
- Omer Dzemali
- Department of Cardiac Surgery Triemli City Hospital Zurich Zurich Switzerland
- Daniel Zimpfer
- Department of Cardiac Surgery Medical University of Vienna Vienna Austria
- Elfriede Ruttmann‐Ulmer
- Department of Cardiac Surgery Medical University of Innsbruck Innsbruck Austria
- Christian Schlensak
- Department of Cardio‐Thoracic and Vascular Surgery University of Tübingen Tübingen Germany
- Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty Düsseldorf Germany
- Stephan Ensminger
- Department of Cardiac and Thoracic Vascular Surgery University Hospital of Schleswig‐Holstein Lübeck Germany
- Udo Boeken
- Department of Cardiac Surgery Heinrich Heine University, Medical Faculty Moorenstr. 5 Düsseldorf 40225 Germany
- DOI
- https://doi.org/10.1002/ehf2.13718
- Journal volume & issue
-
Vol. 9,
no. 1
pp. 506 – 518
Abstract
Abstract Aims 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.
Keywords
- Extracorporeal life support (ECLS)
- Extracorporeal membrane oxygenation (ECMO)
- Cardiac and circulatory failure
- Guideline
- Recommendation
