ECMO during the COVID-19 pandemic: when is it unjustified?

Abrams, Darryl; Lorusso, Roberto; Vincent, Jean Louis; Brodie, Daniel

doi:10.1186/s13054-020-03230-9

Cited by 49 publications

(57 citation statements)

References 12 publications

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“…We thank the authors for their thoughtful reply to our article "ECMO during the COVID-19 pandemic: when is it unjustified?" [1], in which they suggest the use of triage committees to ensure fair allocation of ECMO during the COVID-19 pandemic, an issue we raised in our article. We also appreciate the greater focus given to this important issue by the authors.…”

Section: Darryl Abrams Roberto Lorusso Jean-louis Vincent and Danimentioning

confidence: 99%

“…Procedural justice and egalitarian principles for rationing decisions in the COVID-19 crisis Alexander Supady 1,2,3* , Christoph Bode 1,2 and Daniel Duerschmied 1,2 In their insightful editorial on the justification for extracorporeal membrane oxygenation (ECMO) treatment in the coronavirus disease 2019 (COVID-19) pandemic, Abrams et al argue for a utilitarian principle "reserving ECMO only for those patients who are most likely to derive benefit"-and consequently withholding ECMO from others with less desirable prospects [1]. We doubt that the utilitarian approach is appropriate in this context; therefore, we would like to suggest an alternative approach.…”

mentioning

confidence: 99%

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Procedural justice and egalitarian principles for rationing decisions in the COVID-19 crisis

2020

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Section: Darryl Abrams Roberto Lorusso Jean-louis Vincent and Danimentioning

confidence: 99%

mentioning

confidence: 99%

Procedural justice and egalitarian principles for rationing decisions in the COVID-19 crisis

2020

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“…These committees would be in charge of both the rationing decisions—with information from clinicians at the bedside—and the communication of these decisions to patients or surrogates. 11 , 12 , 13 , 14 However, thus far no systematic use of triage committees to make allocation decisions were put in place during the COVID-19 pandemic. 15 The triage committee structure alone does not prescribe the approach to decision making: the values and principles upon which the triage decisions are made must also be defined.…”

Section: Pre-covid-19 Approaches To Rationing Scarce Resourcesmentioning

confidence: 99%

Allocating scarce intensive care resources during the COVID-19 pandemic: practical challenges to theoretical frameworks

Supady

Curtis

Abrams

et al. 2021

The Lancet Respiratory Medicine

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108

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The COVID-19 pandemic strained health-care systems throughout the world. For some, available medical resources could not meet the increased demand and rationing was ultimately required. Hospitals and governments often sought to establish triage committees to assist with allocation decisions. However, for institutions operating under crisis standards of care (during times when standards of care must be substantially lowered in the setting of crisis), relying on these committees for rationing decisions was impractical-circumstances were changing too rapidly, occurring in too many diverse locations within hospitals, and the available information for decision making was notably scarce. Furthermore, a utilitarian approach to decision making based on an analysis of outcomes is problematic due to uncertainty regarding outcomes of different therapeutic options. We propose that triage committees could be involved in providing policies and guidance for clinicians to help ensure equity in the application of rationing under crisis standards of care. An approach guided by egalitarian principles, integrated with utilitarian principles, can support physicians at the bedside when they must ration scarce resources.

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“…1 Alexander Supady and colleagues criticise two elements of the triage or rationing guidance offered in the first wave. 2 The authors suggest that practical experience should lead to rejection of the use of triage committees for allocation decisions and rejection of allocation based purely on the so-called utilitarian principles-they focuse on preference for…”

Section: Ethics and Evidence: Learning Lessons From Pandemic Triagementioning

confidence: 99%

Should we ration extracorporeal membrane oxygenation during the COVID-19 pandemic?

Supady

Badulak

Evans

et al. 2021

The Lancet Respiratory Medicine

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ECMO during the COVID-19 pandemic: when is it unjustified?

Cited by 49 publications

References 12 publications

Procedural justice and egalitarian principles for rationing decisions in the COVID-19 crisis

Procedural justice and egalitarian principles for rationing decisions in the COVID-19 crisis

Allocating scarce intensive care resources during the COVID-19 pandemic: practical challenges to theoretical frameworks

Should we ration extracorporeal membrane oxygenation during the COVID-19 pandemic?

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