Post Date: October 20, 2014
Position Statement on the Use of Extracorporeal Life Support in Patients with Ebola Virus Disease from the Steering Committee, Extracorporeal Life Support Organization
Extracorporeal life support, also known as Extracorporeal Membrane Oxygenation (ECMO), can successfully provide temporary circulatory and pulmonary support for a variety of severe illnesses. To date, use of ECMO has not been reported in a patient with severe Ebola virus disease. Severe Ebola cases may develop cardiac or pulmonary failure. In general, patients are considered for ECMO support with cardiac or respiratory failure that is refractory to conventional therapy (such as fluid resuscitation, vasoactive administration and mechanical ventilation) if the potential for benefit outweighs the potential risks of applying ECMO. Cardiorespiratory failure in Ebola infection appears to be related to multiple organ failure and uncontrolled hemorrhage, for which ECMO may be contraindicated in other diseases. As Ebola is spread via contact with bodily fluids and is often accompanied by coagulopathy, risk of bleeding and fluid exposure to healthcare staff is extremely high given requirements for constant monitoring and significant time in direct patient contact. Such significant potential risks must be weighed against any theoretical benefits of ECMO support in Ebola virus. Based on lack of current experience or evidence, the Extracorporeal Life Support Organization (ELSO) Steering Committee does not at present recommend use of ECMO for treatment of severe Ebola virus disease.
ELSO Steering Committee members are available to discuss issues related to Ebola and extracorporeal support.
Jim Fortenberry M.D. - firstname.lastname@example.org
ELSO Steering Committee Chairperson
Giles Peek M.D. - email@example.com
Euro-ELSO Steering Committee Chairperson
Graeme MacLaren, M.D. - firstname.lastname@example.org
Asia-Pacific ELSO (APELSO) Steering Committee Chairperson
Rodrigo Diaz, M.D. - email@example.com
Javier Kattan, M.D. - firstname.lastname@example.org
Latin-America ELSO (LAELSO) Co-Steering Committee Chairpersons
Suneel Pooboni, M.D. - email@example.com
South and West Asia ELSO (SWACELSO) Steering Committee Chairperson
Please contact the ELSO office at 734 998-6601 for further comment or questions. Centers are also encouraged to contact ELSO with any information or experience regarding a patient with Ebola who receives ECLS/ECMO, or other extracorporeal techniques, as we seek to learn more about this disease process and treatment possibilities that could change future recommendations.