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Resuscitation. 2015 Jun;91:73-5. doi: 10.1016/j.resuscitation.2015.03.021. Epub 2015 Apr 9.

Ethics in the use of extracorporeal cardiopulmonary resuscitation in adults.

Author information

1
Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, United States. Electronic address: kriggs3@jhmi.edu.
2
Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
3
Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, United States.

Abstract

Extracorporeal cardiopulmonary resuscitation (ECPR) promises to be an important advance in the treatment of cardiac arrest. However, ECPR involves ethical challenges that should be addressed as it diffuses into practice. Benefits and risks are uncertain, so the evidence base needs to be further developed, at least through outcomes registries and potentially with randomized trials. To inform decision making, patients' preferences regarding ECPR should be obtained, both from the general population and from inpatients at risk for cardiac arrest. Fair and transparent appropriate use criteria should be developed and could be informed by economic analyses.

KEYWORDS:

Cardiopulmonary resuscitation; Ethics; Extracorporeal membrane oxygenation

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