Thorac Cardiovasc Surg 2021; 69(06): 483-489
DOI: 10.1055/s-0041-1735464
Special Report

Extracorporeal Circulation (ECLS/ECMO) for Cardio-circulatory Failure—Summary of the S3 Guideline

Udo Boeken
1   Department of Cardiac Surgery, Heinrich-Heine-University Medical School, Duesseldorf, Germany
,
Alexander Assmann
1   Department of Cardiac Surgery, Heinrich-Heine-University Medical School, Duesseldorf, Germany
,
Andreas Beckmann
2   German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany
,
Christof Schmid
3   Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
,
Karl Werdan
4   Clinic for Internal Medicine III, University Hospital Halle (Saale), Martin-Luther University, Halle-Wittenberg, Germany
,
Guido Michels
5   Department of Acute and Emergency Care, St Antonius Hospital Eschweiler, Eschweiler, Germany
,
Oliver Miera
6   Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
,
Florian Schmidt
7   Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
,
Stefan Klotz
8   Department of Cardiac Surgery, Segeberger Kliniken, Bad Segeberg, Germany
,
Christoph Starck
9   Department of Cardiothoracic and Vascular Surgery, German Heart Centre, Berlin, German
,
Kevin Pilarczyk
10   Department for Intensive Care Medicine, Imland Hospital Rendsburg, Rendsburg, Schleswig-Holstein, Germany
,
Ardawan Rastan
11   Department of Cardiac and Vascular Thoracic Surgery, Philipps-University Hospital Marburg, Marburg, Germany
,
Marion Burckhardt
12   Department of Health Sciences and Management, Baden-Wuerttemberg Cooperative State University (DHBW), Stuttgart, Germany
,
Monika Nothacker
13   Institute for Medical Knowledge Management, Association of the Scientific Medical Societies (AWMF), Universität Marburg, Marburg, Germany
,
Ralf Muellenbach
14   Department of Anaesthesiology and Critical Care Medicine, Campus Kassel of the University of Southampton, Kassel, Germany
,
York Zausig
15   Department of Anesthesiology and Operative Intensive Care Medicine, Aschaffenburg-Alzenau Hospital, Aschaffenburg, Bavaria, Germany
,
Nils Haake
10   Department for Intensive Care Medicine, Imland Hospital Rendsburg, Rendsburg, Schleswig-Holstein, Germany
,
Heinrich Groesdonk
16   Department of Intensive Care Medicine, Helios Clinic Erfurt, Erfurt, Germany
,
Markus Ferrari
17   HSK, Clinic of Internal Medicine I, Helios-Kliniken, Wiesbaden, Germany
,
Michael Buerke
18   Department of Cardiology, Angiology and Intensive Care Medicine, St. Marienkrankenhaus Siegen, Siegen, Germany
,
Marcus Hennersdorf
19   Department of Cardiology, Pneumology, Angiology and Internal Intensive Care Medicine, SLK-Kliniken Heilbronn, Heilbronn, Germany
,
Mark Rosenberg
20   Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
,
Thomas Schaible
21   Department of Neonatology, University Children's Hospital Mannheim, University of Heidelberg, Mannheim, Germany
,
Harald Köditz
22   Medical University Children's Hospital, Hannover, Germany
,
Stefan Kluge
23   Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
,
Uwe Janssens
24   Medical Clinic and Medical Intensive Care Medicine, St. Antonius Hospital, Eschweiler, Germany
,
Matthias Lubnow
25   Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
,
Andreas Flemmer
26   Division of Neonatology, Dr. v. Hauner Children's Hospital and Perinatal Center Munich—Grosshadern, LMU Munich, Munich, Germany
,
Susanne Herber-Jonat
27   Division of Neonatology, Dr. v. Hauner Children's Hospital and Perinatal Center Munich—Grosshadern, LMU Munich, Germany
,
Lucas Wessel
28   Department of Pediatric Surgery, Medical Faculty Mannheim, University of Heidelberg, Germany
,
Dirk Buchwald
29   Department of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr-University, Bochum, Germany
,
Sven Maier
30   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
Lars Krüger
31   Division of Thoracic and Cardiovascular Surgery, Heart- and Diabetes Centre NRW, Ruhr-University, Bochum, Germany
,
Andreas Fründ
32   Department of Physiotherapy, Heart- and Diabetes Centre NRW, Ruhr-University, Bochum, Germany
,
Rolf Jaksties
33   Deutsche Herzstiftung
,
Stefan Fischer
34   Department of Thoracic Surgery and Lung Support, Ibbenbueren General Hospital, Ibbenbueren, Germany
,
Karsten Wiebe
35   Department of Cardiothoracic Surgery, Münster University Hospital, Münster, Germany
,
Christiane S. Hartog
36   Department of Anesthesiology and Operative Intensive Care Medicine, Charité Universitätsmedizin Berlin, and Klinik Bavaria, Kreischa
,
Omer Dzemali
37   Department of Cardiac Surgery, Triemli City Hospital Zurich, Zurich, Switzerland
,
Daniel Zimpfer
38   Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
,
Elfriede Ruttmann-Ulmer
39   Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
,
Christian Schlensak
40   Department of Cardio-Thoracic and Vascular Surgery, University of Tübingen, Tübingen, Germany
,
Malte Kelm
41   Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University Medical School, Duesseldorf, Germany
,
Stephan Ensminger
42   Department of Cardiac and Thoracic Vascular Surgery, University Hospital of Schleswig-Holstein, Lübeck, Germany
› Author Affiliations
Funding The preparation of this guideline was funded by institutional grants of the German Society of Thoracic and Cardiovascular Surgery (GSTCVS, DGTHG) Berlin, Germany.

Introduction

In Germany, a remarkable increase in the usage of extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) systems has been observed throughout the last year with approximately 3,000 annual ECLS/ECMO implantations since 2015. Despite the widespread use of ECLS/ECMO, there is still lack of evidence-based recommendations and guidelines, particularly associated with indications, contraindications, limitations, and management.[1]

Therefore, in 2015 the German Society for Thoracic and Cardiovascular Surgery (GSTCVS, DGTHG) registered the multidisciplinary S3 guideline “use of extracorporeal circulation life support/extracorporeal membrane oxygenation (ECLS/ECMO) for cardiac and circulatory failure” to create recommendations for ECMO/ECLS systems according to the requirements of the Association of the Scientific Medical Societies in Germany (AWMF) and the Medical Centre for Quality (Ärztliches Zentrum für Qualität, ÄZQ). Although the clinical application of ECMO/ECLS represents the main focus, the guideline also addresses structural and economic issues and was completed in February 2021. This report presents a summary of the methodological concept and accepted recommendations of this guideline.

Note

The complete guideline is published in the enclosed supplement to this issue.




Publication History

Article published online:
21 September 2021

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