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Seminars in Cardiothoracic and Vascular Anesthesia
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Extracorporeal Life Support: Utilization, Cost, Controversy, and Ethics of Trying to Save Lives

Sheri Crow, MD

Mayo Clinic, Rochester, Minnesota, crow.sheri{at}mayo.edu

Anne C. Fischer, MD, PhD

Department of Pediatric Surgery, Children's Medical Center, Dallas

Raquel M. Schears, MD, MPH

Mayo Clinic, Rochester, Minnesota

Since the first successful application of extracorporeal membrane oxygenation (ECMO) in 1972, ECMO’s role in the management of respiratory and circulatory collapse continues to be refined and debated. Randomized clinical trials aimed at establishing efficacy and patient selection criteria have been fraught with ethical challenges. Growing concerns over rising health care costs require that careful evaluations of cost, utilization, and ethical issues surrounding heroic life-saving interventions such as ECMO are undertaken. Continued analyses of ECMO’s place in the medical management of respiratory and circulatory failure will help ensure that ECMO is used for not only prolonging life but also for providing a chance for "quality of life" following recovery from near-fatal illnesses.

Key Words: extracorporeal life support • extracorporeal membrane oxygenation (ECMO) • Extracorporeal Life Support Organization (ELSO)

This version was published on September 1, 2009

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 13, No. 3, 183-191 (2009)
DOI: 10.1177/1089253209347385


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