Odish Mazen, Yi Cassia, Eigner Juliann, Kenner Brininger Amelia, Koenig Kristi L, Willms David, Lerum Suzan, McCaul Scott, Boyd King Ayana, Sutherland George, Cederquist Lynette, Owens Robert L, Pollema Travis
University of California, San Diego Health, San Diego, California, USA.
Scripps Health, San Diego, California, USA.
Disaster Med Public Health Prep. 2021 Jun 8:1-8. doi: 10.1017/dmp.2021.179.
In March 2020, at the onset of the coronavirus disease 2019 (COVID-19) pandemic in the United States, the Southern California Extracorporeal Membrane Oxygenation (ECMO) Consortium was formed. The consortium included physicians and coordinators from the 4 ECMO centers in San Diego County. Guidelines were created to ensure that ECMO was delivered equitably and in a resource effective manner across the county during the pandemic. A biomedical ethicist reviewed the guidelines to ensure ECMO use would provide maximal community benefit of this limited resource. The San Diego County Health and Human Services Agency further incorporated the guidelines into its plans for the allocation of scarce resources. The consortium held weekly video conferences to review countywide ECMO capacity (including census and staffing), share data, and discuss clinical practices and difficult cases. Equipment exchanges between ECMO centers maximized regional capacity. From March 1 to November 30, 2020, consortium participants placed 97 patients on ECMO. No eligible patients were denied ECMO due to lack of resources or capacity. The Southern California ECMO Consortium may serve as a model for other communities seeking to optimize ECMO resources during the current COVID-19 or future pandemics.
2020年3月，在美国2019冠状病毒病（COVID-19）大流行开始时，南加州体外膜肺氧合（ECMO）联盟成立。该联盟包括圣地亚哥县4个ECMO中心的医生和协调员。制定了指南，以确保在大流行期间，ECMO能在全县公平且资源高效地提供。一位生物医学伦理学家审查了这些指南，以确保ECMO的使用能为这种有限资源带来最大的社区效益。圣地亚哥县卫生与公众服务局进一步将这些指南纳入其稀缺资源分配计划。该联盟每周举行视频会议，以审查全县的ECMO能力（包括病例数和人员配备）、共享数据，并讨论临床实践和疑难病例。ECMO中心之间的设备交换使区域能力最大化。在2020年3月1日至11月30日期间，联盟参与者为97名患者实施了ECMO治疗。没有合格患者因资源或能力不足而被拒绝使用ECMO。南加州ECMO联盟可为其他在当前COVID-19疫情或未来大流行期间寻求优化ECMO资源的社区提供一个模式。
