Provision of ECPR during COVID-19: evidence, equity, and ethical dilemmas
Elliott Worku,
Denzil Gill,
Daniel Brodie,
Roberto Lorusso,
Alain Combes,
Kiran Shekar
Affiliations
Elliott Worku
Adult Intensive Care Services, The Prince Charles Hospital
Denzil Gill
Adult Intensive Care Services, The Prince Charles Hospital
Daniel Brodie
Center for Acute Respiratory Failure, New York-Presbyterian Hospital
Roberto Lorusso
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM)
Alain Combes
Institute of Cardiometabolism and Nutrition, Sorbonne Universités, UPMC Univ Paris 06
Kiran Shekar
Adult Intensive Care Services, The Prince Charles Hospital
Abstract The use of extracorporeal cardiopulmonary resuscitation (ECPR) to restore circulation during cardiac arrest is a time-critical, resource-intensive intervention of unproven efficacy. The current COVID-19 pandemic has brought additional complexity and significant barriers to the ongoing provision and implementation of ECPR services. The logistics of patient selection, expedient cannulation, healthcare worker safety, and post-resuscitation care must be weighed against the ethical considerations of providing an intervention of contentious benefit at a time when critical care resources are being overwhelmed by pandemic demand.
