Extracorporeal Life Support Organization

Last updated
Extracorporeal Life Support Organization
Type non-profit organization
Industry Health care
Founded1989
Headquarters,
United States
Website http://www.elso.org/

The Extracorporeal Life Support Organization (ELSO) is a non profit organization established in 1989 supporting health care professionals and scientists who are involved in extracorporeal membrane oxygenation (ECMO). [1] ELSO maintains a registry of both facilities and specialists trained to provide ECMO services. ELSO also maintains registry information that is used to support clinical research, support regulatory agencies, and support individual ELSO centers. ELSO provides educational programs for active centers as well as for facilities who may be involved in the transfer of patients to higher levels of care. [2]

Contents

ELSO Chapters

In addition to the North American-based ELSO organization, chapters have been developed to represent the regional needs of ELSO in the rest of the world. Current chapters [3] include:

ELSO Registry

Since 1989, ELSO has maintained a registry of clinical characteristics and outcomes of patients supported with ECMO. A history of the ELSO registry has been published and demonstrates how it evolved over time from paper documentation, to a modern database with web based data entry. [8] Data managers at each of the ELSO centers use detailed database definitions and a point-of-entry data warning system to minimize errors in data entry, as well as full record validation triggered upon submission of the record to ensure all mandatory fields are completed. The ELSO registry has been instrumental in improving ECMO care, post-cardiac arrest management, pediatric ventricular assist devices, and organ transplantation. [9]

The last formally published ELSO Registry report was in 2017, and contained clinical characteristics, complications, and outcomes of 78,397 patients supported with ECMO. [10] Demonstrating the rapid growth of ECMO, at the beginning of 2020, the ELSO Registry contained information on 129,037 patients from 435 member centers across the world. [11]

With the onset of the COVID-19 pandemic, the ELSO registry began collecting data on the worldwide use of ECMO for patients with COVID-19 and reporting this data on the ELSO website in real time. In September 2020, the outcomes of 1,035 COVID-19 patients supported with ECMO from 213 experienced centers in 36 different countries were published in The Lancet, and demonstrated 38% mortality, which is similar to many other respiratory diseases treated with ECMO. [12]

Guidelines for care

ELSO promulgates guidelines [13] for the care of patients on ECMO. They include overall guidelines about setting up a program, proper equipment, and patient care for certain medical conditions. Additional education on ECMO topics is provided through ELSO published textbooks and training manuals for ECMO specialists. [14] ELSO recognizes centers with exceptional programs, systems, processes, and outcomes with the Award for Excellence in Life Support. [15]

Position statements

ELSO provides position statements on:

Related Research Articles

<span class="mw-page-title-main">Respiratory therapist</span> Practitioner in cardio-pulmonary medicine

A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respiratory therapists sometimes graduate from a college or university with a degree in respiratory therapy and have passed a national board certifying examination. The NBRC is responsible for credentialing as a CRT, or RRT,

<span class="mw-page-title-main">Cardiopulmonary bypass</span> Technique that temporarily takes over the function of the heart and lungs during surgery

Cardiopulmonary bypass (CPB) is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and oxygen to the body. The CPB pump itself is often referred to as a heart-lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment.

<span class="mw-page-title-main">Intensive care medicine</span> Medical care subspecialty, treating critically ill

Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians, or intensivists.

<span class="mw-page-title-main">Extracorporeal membrane oxygenation</span> Technique of providing both cardiac and respiratory support

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. The technology for ECMO is largely derived from cardiopulmonary bypass, which provides shorter-term support with arrested native circulation. The device used is a membrane oxygenator, also known as an artificial lung.

<span class="mw-page-title-main">Acute respiratory distress syndrome</span> Human disease

Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). For those who survive, a decreased quality of life is common.

<span class="mw-page-title-main">Liquid breathing</span> Respiration of oxygen-rich liquid by a normally air-breathing organism

Liquid breathing is a form of respiration in which a normally air-breathing organism breathes an oxygen-rich liquid (such as a perfluorocarbon), rather than breathing air, by selecting a liquid that can hold a large amount of oxygen and is capable of CO2 gas exchange.

An extracorporeal is a medical procedure which is performed outside the body. Extracorporeal devices are the artificial organs that remain outside the body while treating a patient. Extracorporeal devices are useful in hemodialysis and cardiac surgery.

<span class="mw-page-title-main">Scope of practice</span> What a healthcare practitioner is permitted to undertake

Scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency. Each jurisdiction has laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice.

<span class="mw-page-title-main">Pulmonary hemorrhage</span> Medical condition

Pulmonary hemorrhage is an acute bleeding from the lung, from the upper respiratory tract and the trachea, and the pulmonary alveoli. When evident clinically, the condition is usually massive. The onset of pulmonary hemorrhage is characterized by a cough productive of blood (hemoptysis) and worsening of oxygenation leading to cyanosis. Treatment should be immediate and should include tracheal suction, oxygen, positive pressure ventilation, and correction of underlying abnormalities such as disorders of coagulation. A blood transfusion may be necessary.

Geisinger Medical Center (GMC) is a hospital in Danville, Pennsylvania that opened in 1915 as the George F. Geisinger Memorial Hospital. It is the flagship hospital for the Danville-based Geisinger Health System, a primary chain of hospitals and clinics across northeastern and central Pennsylvania.

Polytrauma and multiple trauma are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries, such as a serious head injury in addition to a serious burn. The term is defined via an Injury Severity Score (ISS) equal to or greater than 16. It has become a commonly applied term by US military physicians in describing the seriously injured soldiers returning from Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in Afghanistan. The term is generic, however, and has been in use for a long time for any case involving multiple trauma.

<span class="mw-page-title-main">Membrane oxygenator</span> Device that replaces a lung

A membrane oxygenator is a device used to add oxygen to, and remove carbon dioxide from the blood. It can be used in two principal modes: to imitate the function of the lungs in cardiopulmonary bypass (CPB), and to oxygenate blood in longer term life support, termed extracorporeal membrane oxygenation (ECMO). A membrane oxygenator consists of a thin gas-permeable membrane separating the blood and gas flows in the CPB circuit; oxygen diffuses from the gas side into the blood, and carbon dioxide diffuses from the blood into the gas for disposal.

<span class="mw-page-title-main">Diffuse alveolar damage</span> Medical condition

Diffuse alveolar damage (DAD) is a histologic term used to describe specific changes that occur to the structure of the lungs during injury or disease. Most often DAD is described in association with the early stages of acute respiratory distress syndrome (ARDS). It is important to note that DAD can be seen in situations other than ARDS (such as acute interstitial pneumonia) and that ARDS can occur without DAD.

<span class="mw-page-title-main">Liquid ventilator</span> Medical device

A liquid ventilator is similar to a medical ventilator except that it should be able to ensure reliable total liquid ventilation with a breatheable liquid ·. Liquid ventilators are prototypes that may have been used for animal experimentations but experts recommend continued development of a liquid ventilator toward clinical applications.

<span class="mw-page-title-main">Baricitinib</span> Chemical compound

Baricitinib, sold under the brand name Olumiant among others, is an immunomodulatory medication used for the treatment of rheumatoid arthritis, alopecia areata, and COVID-19. It acts as an inhibitor of janus kinase (JAK), blocking the subtypes JAK1 and JAK2.

Robert (Bob) Bartlett is an American physician and medical researcher who is credited with developing a lifesaving heart-lung technology known as extracorporeal membrane oxygenation (ECMO). He is an emeritus professor of surgery at the University of Michigan Medical School.

Extracorporeal cardiopulmonary resuscitation is a method of cardiopulmonary resuscitation (CPR) that passes the patient's blood through a machine in a process to oxygenate the blood supply. A portable extracorporeal membrane oxygenation (ECMO) device is used as an adjunct to standard CPR. A patient who is deemed to be in cardiac arrest refractory to CPR has percutaneous catheters inserted into the femoral vein and artery. Theoretically, the application of ECPR allows for the return of cerebral perfusion in a more sustainable manner than with external compressions alone. By attaching an ECMO device to a person who has acutely undergone cardiovascular collapse, practitioners can maintain end-organ perfusion whilst assessing the potential reversal of causal pathology, with the goal of improving long-term survival and neurological outcomes.

Bridge therapy is therapy intended, in transportation metaphor, to serve as a figurative bridge to another stage of therapy or health, carrying a patient past a challenging period of some kind. There are various types of bridge therapy, such as bridge to transplant, bridge to candidacy, bridge to decision, bridge to recovery, and anticoagulation bridge. Bridge therapy exists in contrast to destination therapy, which is the figurative destination rather than a bridge to something else.

Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups can take nirmatrelvir/ritonavir or remdesivir, either of which reduces the risk of serious illness or hospitalization. In the US, the Biden Administration COVID-19 action plan includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive.

<span class="mw-page-title-main">Theodor Kolobow</span> American physician, scientist

Theodor Kolobow was an American physician, scientist, physiologist, and inventor of medical devices, including the membrane oxygenator, common to most modern ventilators.

References

  1. Cooper DS, Jacobs JP, Moore L, Stock A, Gaynor JW, Chancy T, et al. (2007). "Cardiac extracorporeal life support: state of the art in 2007". Cardiol Young. 17 (Suppl 2): 104–15. doi:10.1017/S1047951107001217. PMID   18039404. S2CID   206304339.
  2. Kim K, Mazor RL, Rycus PT, Brogan TV (2011). "Use of venovenous extracorporeal life support in pediatric patients for cardiac indications: A review of the Extracorporeal Life Support Organization registry". Pediatr Crit Care Med. 13 (3): 285–9. doi:10.1097/PCC.0b013e31822f1586. PMID   21926665. S2CID   24492898.
  3. "Extracorporeal Life Support Organization - ECMO and ECLS > Members > Chapters". www.elso.org. Retrieved 2015-09-17.
  4. "Euro-ELSO". www.euroelso.net. Retrieved 2020-05-09.
  5. "AP-ELSO". www.elso.org. Retrieved 2020-05-12.
  6. "LA-ELSO". www.elso.org. Retrieved 2020-05-12.
  7. "South and West Asia Africa chapter Elso | ECMO Society of India". www.swac-elso.com. Archived from the original on 2014-12-22. Retrieved 2015-09-17.
  8. Lorusso, Roberto; Alexander, Peta; Rycus, Peter; Barbaro, Ryan (January 2019). "The Extracorporeal Life Support Organization Registry: update and perspectives". Annals of Cardiothoracic Surgery. 8 (1): 93–98. doi: 10.21037/acs.2018.11.03 . PMC   6379190 . PMID   30854317.
  9. Nasr, Viviane G.; Raman, Lakshmi; Barbaro, Ryan P.; Guner, Yigit; Tonna, Joseph; Ramanathan, Kollengode; Pappalardo, Federico; Thiagarajan, Ravi R.; Alexander, Peta M.A. (August 2019). "Highlights from the Extracorporeal Life Support Organization Registry: 2006–2017". ASAIO Journal. 65 (6): 537–544. doi: 10.1097/MAT.0000000000000863 . ISSN   1058-2916. PMID   30074497. S2CID   51905235.
  10. Thiagarajan, Ravi R.; Barbaro, Ryan P.; Rycus, Peter T.; Mcmullan, D. Michael; Conrad, Steven A.; Fortenberry, James D.; Paden, Matthew L. (2017). "Extracorporeal Life Support Organization Registry International Report 2016". ASAIO Journal. 63 (1): 60–67. doi:10.1097/MAT.0000000000000475. ISSN   1058-2916. PMID   27984321. S2CID   205758344.
  11. "Extracorporeal Life Support Organization - ECMO and ECLS > Registry > Statistics > International Summary". www.elso.org. Retrieved 2020-05-12.
  12. Barbaro, Ryan P.; MacLaren, Graeme; Boonstra, Philip S.; Iwashyna, Theodore J.; Slutsky, Arthur S.; Fan, Eddy; Bartlett, Robert H.; Tonna, Joseph E.; Hyslop, Robert; Fanning, Jeffrey J.; Rycus, Peter T. (2020-09-25). "Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry". The Lancet. 396 (10257): 1071–1078. doi: 10.1016/S0140-6736(20)32008-0 . ISSN   0140-6736. PMC   7518880 . PMID   32987008.
  13. "Extracorporeal Life Support Organization - ECMO and ECLS > Resources > Guidelines". www.elso.org. Retrieved 2015-09-17.
  14. "Extracorporeal Life Support Organization - ECMO and ECLS > Publications". www.elso.org. Retrieved 2015-09-17.
  15. "Extracorporeal Life Support Organization - ECMO and ECLS > Excellence > Vision". www.elso.org. Retrieved 2015-09-17.
  16. Wild, K. Taylor; Rintoul, Natalie; Kattan, Javier; Gray, Brian; Engle, Reviewers: William; Keene, Sarah; Best, Derek; Davis, Carl; DiGeronimo, Robert; Raman, Lakshmi (May 2020). "Extracorporeal Life Support Organization (ELSO): Guidelines for Neonatal Respiratory Failure". ASAIO Journal. 66 (5): 463–470. doi: 10.1097/MAT.0000000000001153 . ISSN   1058-2916. PMID   32282347.
  17. Combes, Alain; Brodie, Daniel; Bartlett, Robert; Brochard, Laurent; Brower, Roy; Conrad, Steve; De Backer, Daniel; Fan, Eddy; Ferguson, Niall (2014-07-25). "Position Paper for the Organization of Extracorporeal Membrane Oxygenation Programs for Acute Respiratory Failure in Adult Patients". American Journal of Respiratory and Critical Care Medicine. 190 (5): 488–96. doi:10.1164/rccm.201404-0630CP. hdl: 2434/238408 . ISSN   1073-449X. PMID   25062496.
  18. MacLaren, Graeme; Dodge-Khatami, Ali; Dalton, Heidi J. (2013-01-01). "Joint Statement on Mechanical Circulatory Support in Children". Pediatric Critical Care Medicine. 14 (5 Suppl 1): S1–S2. doi:10.1097/pcc.0b013e318292dc09. PMID   23735979.
  19. "Extracorporeal Life Support Organization - ECMO and ECLS > Ebola Statement". www.elso.org. Retrieved 2015-09-17.
  20. Zakhary, Bishoy; Shekar, Kiran; Diaz, Rodrigo; Badulak, Jenelle; Johnston, Lindsay; Roeleveld, Peter Paul; Alinier, Guillaume; Lai, Peter Chi Keung; Ramanathan, Kollengode; Moore, Elizabeth; Hassan, Ibrahim (March 2020). "Position Paper on Global Extracorporeal Membrane Oxygenation Education and Educational Agenda for the Future: A Statement From the Extracorporeal Life Support Organization ECMOed Taskforce*". Critical Care Medicine. 48 (3): 406–414. doi:10.1097/CCM.0000000000004158. hdl: 2299/23778 . ISSN   0090-3493. PMID   31833901. S2CID   209342469.
  21. DellaVolpe, Jeffrey; Barbaro, Ryan P.; Cannon, Jeremy W.; Fan, Eddy; Greene, Wendy R.; Gunnerson, Kyle J.; Napolitano, Lena M.; Ovil, Ace; Pamplin, Jeremy C.; Schmidt, Matthieu; Sorce, Lauren R. (April 2020). "Joint Society of Critical Care Medicine-Extracorporeal Life Support Organization Task Force Position Paper on the Role of the Intensivist in the Initiation and Management of Extracorporeal Membrane Oxygenation". Critical Care Medicine. 48 (6): 838–846. doi: 10.1097/CCM.0000000000004330 . ISSN   0090-3493. PMC   7422732 . PMID   32282350.
  22. Broman, Lars Mikael; Taccone, Fabio Silvio; Lorusso, Roberto; Malfertheiner, Maximilian Valentin; Pappalardo, Federico; Di Nardo, Matteo; Belliato, Mirko; Bembea, Melania M.; Barbaro, Ryan P.; Diaz, Rodrigo; Grazioli, Lorenzo (December 2019). "The ELSO Maastricht Treaty for ECLS Nomenclature: abbreviations for cannulation configuration in extracorporeal life support - a position paper of the Extracorporeal Life Support Organization". Critical Care. 23 (1): 36. doi: 10.1186/s13054-019-2334-8 . ISSN   1364-8535. PMC   6367794 . PMID   30736845.
  23. Bartlett, Robert H.; Ogino, Mark T.; Brodie, Daniel; McMullan, David M.; Lorusso, Roberto; MacLaren, Graeme; Stead, Christine M.; Rycus, Peter; Fraser, John F.; Belohlavek, Jan; Salazar, Leonardo (May 2020). "Initial ELSO Guidance Document: ECMO for COVID-19 Patients with Severe Cardiopulmonary Failure". ASAIO Journal. 66 (5): 472–474. doi: 10.1097/MAT.0000000000001173 . ISSN   1058-2916. PMC   7273858 . PMID   32243267.
  24. Shekar, Kiran; Badulak, Jenelle; Peek, Giles; Boeken, Udo; Dalton, Heidi J; Arora, Lovkesh; Zakhary, Bishoy; Ramanathan, Kollengode; Starr, Joanne; Akkanti, Bindu; Antonini, M. Velia (April 2020). "Extracorporeal Life Support Organization COVID-19 Interim Guidelines". ASAIO Journal. 66 (7): 707–721. doi: 10.1097/MAT.0000000000001193 . ISSN   1058-2916. PMC   7228451 . PMID   32604322.