成人体外心肺复苏应用中的伦理问题。
Ethics in the use of extracorporeal cardiopulmonary resuscitation in adults.
作者信息
Riggs Kevin R, Becker Lance B, Sugarman Jeremy
机构信息
Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, United States.
Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
出版信息
Resuscitation. 2015 Jun;91:73-5. doi: 10.1016/j.resuscitation.2015.03.021. Epub 2015 Apr 9.
Abstract
Extracorporeal cardiopulmonary resuscitation (ECPR) promises to be an important advance in the treatment of cardiac arrest. However, ECPR involves ethical challenges that should be addressed as it diffuses into practice. Benefits and risks are uncertain, so the evidence base needs to be further developed, at least through outcomes registries and potentially with randomized trials. To inform decision making, patients' preferences regarding ECPR should be obtained, both from the general population and from inpatients at risk for cardiac arrest. Fair and transparent appropriate use criteria should be developed and could be informed by economic analyses.
摘要
体外心肺复苏术（ECPR）有望成为心脏骤停治疗领域的一项重要进展。然而，ECPR涉及一些伦理挑战，随着其在实践中的推广，这些挑战需要得到解决。益处和风险尚不明确，因此至少需要通过结果登记系统，并可能借助随机试验来进一步完善证据基础。为了为决策提供依据，应该从普通人群以及有心脏骤停风险的住院患者那里了解他们对ECPR的偏好。应该制定公平、透明的合理使用标准，经济分析可为其提供参考。
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