[Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure : Short version of the S3 guideline].

Einsatz der extrakorporalen Zirkulation (ECLS/ECMO) bei Herz- und Kreislaufversagen : Kurzversion der AWMF-S3-Leitlinie.
Association of the Scientific Medical Societies in Germany Cardiac failure Cardiomyopathy ECC ECLS Mechanical circulatory support

Journal

Medizinische Klinik, Intensivmedizin und Notfallmedizin
ISSN: 2193-6226
Titre abrégé: Med Klin Intensivmed Notfmed
Pays: Germany
ID NLM: 101575086

Informations de publication

Date de publication:
Nov 2021
Historique:
pubmed: 20 10 2021
medline: 6 11 2021
entrez: 19 10 2021
Statut: ppublish

Résumé

In Germany, a remarkable increase regarding the usage of extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) systems has been observed in recent years with approximately 3000 ECLS/ECMO implantations annually since 2015. Despite the widespread use of ECLS/ECMO, evidence-based recommendations or guidelines are still lacking regarding indications, contraindications, limitations and management of ECMO/ECLS patients. Therefore in 2015, the German Society of Thoracic and Cardiovascular Surgery (GSTCVS) registered the multidisciplinary S3 guideline "Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure" to develop evidence-based recommendations for ECMO/ECLS systems according to the requirements of the Association of the Scientific Medical Societies in Germany (AWMF). Although the clinical application of ECMO/ECLS represents the main focus, the presented guideline also addresses structural and economic issues. Experts from 17 German, Austrian and Swiss scientific societies and a patients' organization, guided by the GSTCVS, completed the project in February 2021. In this report, we present a summary of the methodological concept and tables displaying the recommendations for each chapter of the guideline. Seit einigen Jahren ist eine stetige Zunahme des Einsatzes von mechanischen extrakorporalen Herz-Kreislauf- und Lungenunterstützungssystemen (ECLS/ECMO) zu verzeichnen. So wurden seit 2015 in Deutschland jährlich bei etwa 3000 Patienten ECLS/ECMO-Systeme implantiert. Trotz dieser häufigen Anwendung der passageren Unterstützungssysteme existieren zurzeit national und international nur Leitlinien zum Einsatz der ECMO/ECLS, die erkrankungsbezogene Teilaspekte komplexer Therapiekaskaden adressieren. Vor diesem Hintergrund erschien es notwendig, evidenzbasierte Empfehlungen zur ECLS/ECMO-Therapie im Hinblick auf Indikationen und das komplexe Patientenmanagement zu verfassen, in denen personelle, prozessuale und infrastrukturelle Anforderungen definiert werden. Aus diesem Grund erfolgte im Juli 2015 durch die Deutsche Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG) die Anmeldung einer diesbezüglichen S3-Leitlinie bei der zuständigen Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF). Im Mittelpunkt der Leitlinie steht die klinische Anwendung der ECLS/ECMO-Therapie; ergänzend werden auch strukturelle und ökonomische Aspekte adressiert. Unter Federführung der DGTHG wurde mit Einbindung von Experten aus Deutschland, Österreich und der Schweiz, delegiert aus 11 AWMF-Fachgesellschaften, 5 weiteren Fachgesellschaften sowie der Patientenvertretung, die S3-Leitlinie im Februar 2021 publiziert. Dieser Artikel stellt eine kurze Zusammenfassung des methodischen Konzepts sowie aller konsentierten Empfehlungen für jede bearbeitete Fragestellung der Leitlinie dar.

Autres résumés

Type: Publisher (ger)
Seit einigen Jahren ist eine stetige Zunahme des Einsatzes von mechanischen extrakorporalen Herz-Kreislauf- und Lungenunterstützungssystemen (ECLS/ECMO) zu verzeichnen. So wurden seit 2015 in Deutschland jährlich bei etwa 3000 Patienten ECLS/ECMO-Systeme implantiert. Trotz dieser häufigen Anwendung der passageren Unterstützungssysteme existieren zurzeit national und international nur Leitlinien zum Einsatz der ECMO/ECLS, die erkrankungsbezogene Teilaspekte komplexer Therapiekaskaden adressieren. Vor diesem Hintergrund erschien es notwendig, evidenzbasierte Empfehlungen zur ECLS/ECMO-Therapie im Hinblick auf Indikationen und das komplexe Patientenmanagement zu verfassen, in denen personelle, prozessuale und infrastrukturelle Anforderungen definiert werden. Aus diesem Grund erfolgte im Juli 2015 durch die Deutsche Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG) die Anmeldung einer diesbezüglichen S3-Leitlinie bei der zuständigen Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF). Im Mittelpunkt der Leitlinie steht die klinische Anwendung der ECLS/ECMO-Therapie; ergänzend werden auch strukturelle und ökonomische Aspekte adressiert. Unter Federführung der DGTHG wurde mit Einbindung von Experten aus Deutschland, Österreich und der Schweiz, delegiert aus 11 AWMF-Fachgesellschaften, 5 weiteren Fachgesellschaften sowie der Patientenvertretung, die S3-Leitlinie im Februar 2021 publiziert. Dieser Artikel stellt eine kurze Zusammenfassung des methodischen Konzepts sowie aller konsentierten Empfehlungen für jede bearbeitete Fragestellung der Leitlinie dar.

Identifiants

pubmed: 34665281
doi: 10.1007/s00063-021-00868-3
pii: 10.1007/s00063-021-00868-3
doi:

Types de publication

Journal Article Review

Langues

ger

Sous-ensembles de citation

IM

Pagination

678-686

Informations de copyright

© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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Auteurs

Udo Boeken (U)

Department of Cardiac Surgery, Heinrich Heine University Medical School, Moorenstraße 5, 40225, Düsseldorf, Deutschland. udo.boeken@med.uni-duesseldorf.de.

Stephan Ensminger (S)

Department of Cardiac and Thoracic Vascular Surgery, University Hospital of Schleswig-Holstein, Lübeck, Deutschland.

Alexander Assmann (A)

Department of Cardiac Surgery, Heinrich Heine University Medical School, Moorenstraße 5, 40225, Düsseldorf, Deutschland.

Christof Schmid (C)

Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Deutschland.

Karl Werdan (K)

Clinic for Internal Medicine III, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle-Wittenberg, Deutschland.

Guido Michels (G)

Department of Acute and Emergency Care, St Antonius Hospital Eschweiler, Eschweiler, Deutschland.

Oliver Miera (O)

Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.

Florian Schmidt (F)

Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Deutschland.

Stefan Klotz (S)

Department of Cardiac Surgery, Segeberger Kliniken, Bad Segeberg, Deutschland.

Christoph Starck (C)

Department of Cardiothoracic and Vascular Surgery, German Heart Center, Berlin, Deutschland.

Kevin Pilarczyk (K)

Imland Hospital Rendsburg, Department for Intensive Care Medicine, Rendsburg, Schleswig-Holstein, Deutschland.

Ardawan Rastan (A)

Department of Cardiac and Vascular Thoracic Surgery, Philipps University Hospital Marburg, Marburg, Deutschland.

Marion Burckhardt (M)

Department of Health Sciences and Management, Baden-Wuerttemberg Cooperative State University (DHBW)-Stuttgart, Stuttgart, Deutschland.

Monika Nothacker (M)

Institute for Medical Knowledge Management, Association of the Scientific Medical Societies (AWMF), Universität Marburg, Marburg, Deutschland.

Ralf Muellenbach (R)

Department of Anesthesiology and Critical Care Medicine, Campus Kassel of the University of Southampton, Kassel, Deutschland.

York Zausig (Y)

Department of Anesthesiology and Operative Intensive Care Medicine, Aschaffenburg-Alzenau Hospital, Aschaffenburg, Bavaria, Deutschland.

Nils Haake (N)

Imland Hospital Rendsburg, Department for Intensive Care Medicine, Rendsburg, Schleswig-Holstein, Deutschland.

Heinrich Groesdonk (H)

Department of Intensive Care Medicine, Helios Clinic Erfurt, 99089, Erfurt, Deutschland.

Markus Ferrari (M)

HSK, Clinic of Internal Medicine I, Helios-Kliniken, Wiesbaden, Deutschland.

Michael Buerke (M)

Department of Cardiology, Angiology and Internal Intensive Care Medicine, St. Marienkrankenhaus Siegen, Siegen, Deutschland.

Marcus Hennersdorf (M)

Department of Cardiology, Pneumology, Angiology and Internal Intensive Care Medicine, SLK-Kliniken Heilbronn, Heilbronn, Deutschland.

Mark Rosenberg (M)

Department of Internal Medicine I, Hospital Aschaffenburg-Alzenau, Aschaffenburg-Alzenau, Deutschland.

Thomas Schaible (T)

Department of Neonatology, University Children's Hospital Mannheim, University of Heidelberg, Mannheim, Deutschland.

Harald Köditz (H)

Medical University Children's Hospital, Hannover, Deutschland.

Stefan Kluge (S)

Department of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland.

Uwe Janssens (U)

Medical Clinic and Medical Intensive Care Medicine, St Antonius Hospital, Eschweiler, Deutschland.

Matthias Lubnow (M)

Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Deutschland.

Andreas Flemmer (A)

Division of Neonatology, Dr. v. Hauner Children's Hospital and Perinatal Center Munich-Grosshadern, LMU Munich, Munich, Deutschland.

Susanne Herber-Jonat (S)

Division of Neonatology, Dr. v. Hauner Children's Hospital and Perinatal Center Munich-Grosshadern, LMU Munich, Munich, Deutschland.

Lucas Wessel (L)

Department of Pediatric Surgery, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Deutschland.

Dirk Buchwald (D)

Department of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr University, Bochum, Deutschland.

Sven Maier (S)

Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Deutschland.

Lars Krüger (L)

Division of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Deutschland.

Andreas Fründ (A)

Department of Physiotherapy, Heart and Diabetes Center NRW, Ruhr University, Bochum, Bochum, Deutschland.

Rolf Jaksties (R)

German Heart Foundation, Frankfurt am Main, Deutschland.

Stefan Fischer (S)

Department of Thoracic Surgery and Lung Support, Ibbenbueren General Hospital, Ibbenbueren, Deutschland.

Karsten Wiebe (K)

Department of Cardiothoracic Surgery, Münster University Hospital, Münster, Deutschland.

Christiane Hartog (C)

Department of Anesthesiology and Operative Intensive Care Medicine, Charité, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.

Omer Dzemali (O)

Department of Cardiac Surgery, Triemli City Hospital Zurich, Birmensdorferstraße 497, 8063, Zurich, Schweiz.

Daniel Zimpfer (D)

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Österreich.

Elfriede Ruttmann-Ulmer (E)

Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.

Christian Schlensak (C)

Department of Cardiothoracic and Vascular Surgery, University of Tübingen, Tübingen, Deutschland.

Malte Kelm (M)

Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Medical School, Moorenstraße 5, Duesseldorf, Deutschland.

Andreas Beckmann (A)

German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Luisenstraße 58/59, Berlin, Deutschland.

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