Division of Pediatric Surgery, Department of Surgery, School of Medicine, Washington University in St Louis, St Louis, Missouri.
Trent Center for Bioethics, Humanities and History of Medicine, School of Medicine, Duke University, Durham, North Carolina.
Pediatrics. 2020 Sep;146(3). doi: 10.1542/peds.2020-012542. Epub 2020 Jul 9.
Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and health policy discuss if age should guide rationing decisions.
新型冠状病毒病 2019 可导致呼吸衰竭。一些患者需要体外膜氧合支持。在当前大流行期间,一些城市的医疗资源已经不堪重负,医生面临着关于资源分配的复杂决策。我们介绍了一个儿科医院,它同时照顾儿童和成人,如果没有足够的资源治疗每个患者,该医院试图制定体外膜氧合使用指南的案例。重症监护、临终关怀、生物伦理学和卫生政策方面的专家讨论了年龄是否应指导配给决策。