TY - JOUR
T1 - Extracorporeal membrane oxygenation in adults receiving haematopoietic cell transplantation: an international expert statement
AU - Di Nardo, Matteo
AU - MacLaren, Graeme
AU - Schellongowski, Peter
AU - Azoulay, Elie
AU - DeZern, Amy E.
AU - Gutierrez, Cristina
AU - Antonelli, Massimo
AU - Antonini, Marta
AU - Beutel, Gernot
AU - Combes, Alain
AU - Diaz, Rodrigo
AU - Hassan, Ibrahim Fawzy
AU - Fowles, Jo-Anne
AU - Jeong, In-Seok
AU - Kochanek, Matthias
AU - Liebregts, Tobias
AU - Lueck, Catherina
AU - Moody, Karen
AU - Moore, Jessica A.
AU - Munshi, Laveena
AU - Paden, Matthew
AU - Pene, Frederic
AU - Puxty, Kathryn
AU - Schmidt, Matthieu
AU - Staudacher, Dawid
AU - Staudinger, Thomas
AU - Stemmler, Joachim
AU - Stephens, R. Scott
AU - Vande Vusse, Lisa
AU - Wohlfarth, Philipp
AU - Lorusso, Roberto
AU - Amodeo, Antonio
AU - Mahadeo, Kris M.
AU - Brodie, Daniel
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Combined advances in haematopoietic cell transplantation (HCT) and intensive care management have improved the survival of patients with haematological malignancies admitted to the intensive care unit. In cases of refractory respiratory failure or refractory cardiac failure, these advances have led to a renewed interest in advanced life support therapies, such as extracorporeal membrane oxygenation (ECMO), previously considered inappropriate for these patients due to their poor prognosis. Given the scarcity of evidence-based guidelines on the use of ECMO in patients receiving HCT and the need to provide equitable and sustainable access to ECMO, the European Society of Intensive Care Medicine, the Extracorporeal Life Support Organization, and the International ECMO Network aimed to develop an expert consensus statement on the use of ECMO in adult patients receiving HCT. A steering committee with expertise in ECMO and HCT searched the literature for relevant articles on ECMO, HCT, and immune effector cell therapy, and developed opinion statements through discussions following a Quaker-based consensus approach. An international panel of experts was convened to vote on these expert opinion statements following the Research and Development/University of California, Los Angeles Appropriateness Method. The Appraisal of Guidelines for Research and Evaluation statement was followed to prepare this Position Paper. 36 statements were drafted by the steering committee, 33 of which reached strong agreement after the first voting round. The remaining three statements were discussed by all members of the steering committee and expert panel, and rephrased before an additional round of voting. At the conclusion of the process, 33 statements received strong agreement and three weak agreement. This Position Paper could help to guide intensivists and haematologists during the difficult decision-making process regarding ECMO candidacy in adult patients receiving HCT. The statements could also serve as a basis for future research focused on ECMO selection criteria and bedside management.
AB - Combined advances in haematopoietic cell transplantation (HCT) and intensive care management have improved the survival of patients with haematological malignancies admitted to the intensive care unit. In cases of refractory respiratory failure or refractory cardiac failure, these advances have led to a renewed interest in advanced life support therapies, such as extracorporeal membrane oxygenation (ECMO), previously considered inappropriate for these patients due to their poor prognosis. Given the scarcity of evidence-based guidelines on the use of ECMO in patients receiving HCT and the need to provide equitable and sustainable access to ECMO, the European Society of Intensive Care Medicine, the Extracorporeal Life Support Organization, and the International ECMO Network aimed to develop an expert consensus statement on the use of ECMO in adult patients receiving HCT. A steering committee with expertise in ECMO and HCT searched the literature for relevant articles on ECMO, HCT, and immune effector cell therapy, and developed opinion statements through discussions following a Quaker-based consensus approach. An international panel of experts was convened to vote on these expert opinion statements following the Research and Development/University of California, Los Angeles Appropriateness Method. The Appraisal of Guidelines for Research and Evaluation statement was followed to prepare this Position Paper. 36 statements were drafted by the steering committee, 33 of which reached strong agreement after the first voting round. The remaining three statements were discussed by all members of the steering committee and expert panel, and rephrased before an additional round of voting. At the conclusion of the process, 33 statements received strong agreement and three weak agreement. This Position Paper could help to guide intensivists and haematologists during the difficult decision-making process regarding ECMO candidacy in adult patients receiving HCT. The statements could also serve as a basis for future research focused on ECMO selection criteria and bedside management.
U2 - 10.1016/S2213-2600(22)00535-5
DO - 10.1016/S2213-2600(22)00535-5
M3 - Article
C2 - 36924784
SN - 2213-2600
VL - 11
SP - 477
EP - 492
JO - The Lancet Respiratory medicine
JF - The Lancet Respiratory medicine
IS - 5
ER -