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Aktuelle Kardiologie 2022; 11(04): 358-366
DOI: 10.1055/a-1734-4157
Originalarbeit

Empfehlungen der S3-Leitlinie (AWMF) Einsatz der extrakorporalen Zirkulation (ECLS/ECMO) bei Herz- und Kreislaufversagen

Recommendations of the S3 Guideline Use of Extracorporeal Circulation (ECLS/ECMO) for Cardiac and Circulatory Failure
Alexander Assmann 
1   Department of Cardiac Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
,
Andreas Beckmann
2   German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany
,
Christof Schmid
3   Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
,
Karl Werdan
4   Clinic for Internal Medicine III, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
,
Guido Michels
5   Department of Acute and Emergency Care, St. Antonius Hospital Eschweiler, Eschweiler, Germany
,
Oliver Miera
6   Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
,
Florian Schmidt
7   Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
,
Stefan Klotz
8   Department of Cardiac Surgery, Segeberger Kliniken Bad Segeberg, Bad Segeberg, Germany
,
Christoph Starck
9   Department of Cardiothoracic & Vascular Surgery, German Heart Centre, Berlin, Deutschland
,
Kevin Pilarczyk
10   Department for Intensice Care Medicine, Imland Hospital Rendsburg, Rendsburg, Germany
,
Ardawan Rastan
11   Department of Cardiac and Vascular Thoracic Surgery, Philipps-University Hospital Marburg, Marburg, Germany
,
Marion Burckhardt
12   Department of Health Sciences and Management, Baden-Wuerttemberg Cooperative State University (DHBW)-Stuttgart, Stuttgart, Germany
,
Monika Nothacker
13   Institute for Medical Knowledge Management, Association of the Scientific Medical Societies (AWMF), Universität Marburg, Marburg, Germany
,
Ralf Muellenbach
14   Department of Anaesthesiology and Critical Care Medicine, Campus Kassel of the University of Southampton, Kassel, Germany
,
York Zausig
15   Department of Anesthesiology and Operative Intensive Care Medicine, Aschaffenburg-Alzenau Hospital, Aschaffenburg, Germany
,
Nils Haake
10   Department for Intensice Care Medicine, Imland Hospital Rendsburg, Rendsburg, Germany
,
Heinrich Groesdonk
16   Department of Intensive Care Medicine, Helios Clinic Erfurt, Erfurt, Germany
,
Markus Ferrari
17   HSK, Clinic of Internal Medicine I, Helios-Kliniken, Wiesbaden, Germany
,
Michael Buerke
18   Department of Cardiology, Angiology and Internal Intensive Care Medicine, St. Marienkrankenhaus Siegen, Siegen, Germany
,
Marcus Hennersdorf
19   Department of Cardiology, Pneumology, Angiology and Internal Intensive Care Medicine, SLK-Kliniken Heilbronn, Heilbronn, Germany
,
Mark Rosenberg
20   Medizinische Klinik I, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
,
Thomas Schaible
21   Department of Neonatology, University Children's Hospital Mannheim, University of Heidelberg, Heidelberg, Germany
,
Harald Köditz
22   Medical University Children's Hospital Hannover, Hannover, Germany
,
Stefan Kluge
23   Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
,
Uwe Janssens
24   Medical Clinic and Medical Intensive Care Medicine, St. Antonius Hospital, Eschweiler, Germany
,
Matthias Lubnow
25   Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
,
Andreas Flemmer
26   Division of Neonatology, Dr. v. Hauner Children's Hospital and Perinatal Center Munich - Grosshadern, LMU Munich, München, Germany
,
Susanne Herber-Jonat
26   Division of Neonatology, Dr. v. Hauner Children's Hospital and Perinatal Center Munich - Grosshadern, LMU Munich, München, Germany
,
Lucas Wessel
27   Department of Pediatric Surgery, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Deutschland
,
Dirk Buchwald
28   Department of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
,
Sven Maier
29   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
Lars Krüger
30   Division of Thoracic and Cardiovascular Surgery, Heart- and Diabetescentre NRW, Ruhr-University Bochum, Bochum, Germany
,
Andreas Fründ
31   Department of Physiotherapy, Heart- and Diabetescentre NRW, Ruhr-University Bochum, Bochum, Germany
,
Rolf Jaksties
32   German Heart Foundation, Berlin, Germany
,
Stefan Fischer
33   Department of Thoracic Surgery and Lung Support, Ibbenbueren General Hospital, Ibbenbueren, Germany
,
Karsten Wiebe
34   Department of Cardiothoracic Surgery, Münster University Hospital, Münster, Germany
,
Christiane Hartog
35   Department of Anesthesiology and Operative Intensive Care Medicine, Charité, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
,
Omer Dzemali
36   Department of Cardiac Surgery, Triemli City Hospital Zurich, Zürich, Switzerland
,
Daniel Zimpfer
37   Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
,
Elfriede Ruttmann-Ulmer
38   Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
,
Christian Schlensak
39   Department of Cardio-Thoracic and Vascular Surgery, University of Tübingen, Tübingen, Germany
,
Stephan Ensminger
40   Department of Cardiac and Thoracic Vascular Surgery, University Hospital of Schleswig-Holstein, Lübeck, Germany
,
Malte Kelm
41   Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University Medical School, Düsseldorf, Germany
,
Udo Boeken
1   Department of Cardiac Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
› InstitutsangabenGefördert durch: Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie (DGTHG)
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Zusammenfassung

In den vergangenen Jahren hat der Einsatz mechanischer Unterstützungssysteme für Patienten mit Herz- und Kreislaufversagen kontinuierlich zugenommen, sodass in Deutschland mittlerweile jährlich etwa 3000 ECLS/ECMO-Systeme implantiert werden. Vor dem Hintergrund bislang fehlender umfassender Leitlinien bestand ein dringlicher Bedarf an der Formulierung evidenzbasierter Empfehlungen zu den zentralen Aspekten der ECLS/ECMO-Therapie.

Im Juli 2015 wurde daher die Erstellung einer S3-Leitlinie durch die Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie (DGTHG) bei der zuständigen Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) angemeldet. In einem strukturierten Konsensusprozess mit Einbindung von Experten aus Deutschland, Österreich und der Schweiz, delegiert aus 11 AWMF-Fachgesellschaften, 5 weiteren Fachgesellschaften sowie der Patientenvertretung, entstand unter Federführung der DGTHG die Leitlinie „Einsatz der extrakorporalen Zirkulation (ECLS/ECMO) bei Herz- und Kreislaufversagen“, die im Februar 2021 publiziert wurde.

Die Leitlinie fokussiert auf klinische Aspekte der Initiierung, Fortführung, Entwöhnung und Nachsorge und adressiert hierbei auch strukturelle und ökonomische Fragestellungen. Dieser Artikel präsentiert eine Übersicht zu der Methodik und den konsentierten Empfehlungen.

Abstract

In recent years, the use of mechanical support for patients with cardiac or circulatory failure has continuously increased, leading to 3000 ECLS/ECMO (extracorporeal life support/extracorporeal membrane oxygenation) implantations annually in Germany. Due to the lack of guidelines, an urgent need for evidence-based recommendations addressing the central aspects of ECLS/ECMO therapy has existed.

In July 2015, the generation of a guideline level S3 according to the standards of the Association of the Scientific Medical Societies in Germany (AWMF) was announced by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS). In a well-structured consensus process, involving experts from Germany, Austria and Switzerland, delegated by 16 scientific societies and the patients’ representation, the guideline “Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure” was created under guidance of the GSTCVS, and published in February 2021.

The guideline focuses on clinical aspects of initiation, continuation, weaning and aftercare, herein also addressing structural and economic issues. This article presents an overview on the methodology as well as the final recommendations.

Schlüsselwörter

Leitlinie - Extrakorporale Membranoxygenierung (ECMO) - Extracorporeal Life Support (ECLS) - Herz-Kreislauf-Versagen

Keywords

guideline - extracorporeal membrane oxygenation (ECMO) - extracorporeal life support (ECLS) - cardiac and circulatory failure


Publikationsverlauf

Artikel online veröffentlicht:
08. Juni 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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