Martin Archer Kilbourne, Mercier Olaf, Fritz Ashley Virginia, Gelzinis Theresa A, Hoetzenecker Konrad, Lindstedt Sandra, Marczin Nandor, Wilkey Barbara J, Schecter Marc, Lyster Haifa, Sanchez Melissa, Walsh James, Morrissey Orla, Levvey Bronwyn, Landry Caroline, Saatee Siavosh, Kotecha Sakhee, Behr Juergen, Kukreja Jasleen, Dellgren Göran, Fessler Julien, Bottiger Brandi, Wille Keith, Dave Kavita, Nasir Basil S, Gomez-De-Antonio David, Cypel Marcelo, Reed Anna K
Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic Florida, Jacksonville, Florida.
Department of Thoracic Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Universite' Paris-Saclay, Le Plessis-Robinson, France.
J Heart Lung Transplant. 2024 Oct 9. doi: 10.1016/j.healun.2024.08.027.
The use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no multidisciplinary consensus document has examined the perioperative considerations of how to best manage these patients. To address this challenge, this perioperative utilization of ECLS in lung transplantation consensus statement was approved for development by the International Society for Heart and Lung Transplantation Standards and Guidelines Committee. International experts across multiple disciplines, including cardiothoracic surgery, anesthesiology, critical care, pediatric pulmonology, adult pulmonology, pharmacy, psychology, physical therapy, nursing, and perfusion, were selected based on expertise and divided into subgroups examining the preoperative, intraoperative, and postoperative periods. Following a comprehensive literature review, each subgroup developed recommendations to examine via a structured Delphi methodology. Following 2 rounds of Delphi consensus, a total of 39 recommendations regarding intraoperative considerations for ECLS in lung transplantation met consensus criteria. These recommendations focus on the planning, implementation, management, and monitoring of ECLS throughout the entire intraoperative period.
在肺移植围手术期使用体外生命支持（ECLS）需要多学科专家组成的综合团队进行细致入微的规划和实施。迄今为止，尚无多学科共识文件探讨如何最佳管理这些患者的围手术期注意事项。为应对这一挑战，国际心肺移植学会标准与指南委员会批准制定这份关于肺移植围手术期ECLS应用的共识声明。基于专业知识，挑选了包括心胸外科、麻醉学、重症监护、儿科肺病学、成人肺病学、药学、心理学、物理治疗、护理和灌注等多个学科的国际专家，并将其分为几个小组，分别研究术前、术中和术后阶段。在进行全面的文献综述后，每个小组制定了建议，通过结构化德尔菲法进行审查。经过两轮德尔菲共识达成，共有39条关于肺移植术中ECLS注意事项的建议达到了共识标准。这些建议聚焦于整个术中阶段ECLS的规划、实施、管理和监测。
