Evidence map›Paper›PMID 33498412›Full record

ReviewJournal of clinical medicine2021

Do-(Not-)Mechanical-Circulatory-Support Orders: Should We Ask All Cardiac Surgery Patients for Informed Consent for Post-Cardiotomy Extracorporeal Life Circulatory Support?

Jorik Simons, Martje Suverein, Walther van Mook, Kadir Caliskan, Osama Soliman, Marcel van de Poll, Thijs Delnoij, Jos Maessen, Barend Mees, Roberto Lorusso

Open access · goldAbstract readReview
In one paragraph

Review in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Ethics in extracorporeal life support: a narrative review.Critical care (London, England) · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Jorik SimonsDepartment of Cardio-Thoracic Surgery, CARIM School for Cardiovascular Diseases, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.
Martje SuvereinDepartment of Intensive Care Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.
Walther van MookDepartment of Intensive Care Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.
Kadir CaliskanDepartment of Cardiology, Heart Failure, Heart Transplantation and Mechanical Circulatory Support, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands.
Osama SolimanDepartment of Cardiology, School of Medicine, National University of Ireland, H91 TK33 Galway, Ireland.ORCID 0000-0003-0758-3539
Marcel van de PollDepartment of Intensive Care Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.ORCID 0000-0002-3302-4063
Thijs DelnoijDepartment of Intensive Care Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.
Jos MaessenDepartment of Cardio-Thoracic Surgery, CARIM School for Cardiovascular Diseases, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.
Barend MeesDepartment of Vascular Surgery, CARIM School for Cardiovascular Diseases, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.ORCID 0000-0001-6545-5813
Roberto LorussoDepartment of Cardio-Thoracic Surgery, CARIM School for Cardiovascular Diseases, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands.ORCID 0000-0002-1777-2045
Maastricht University Medical Centre · NLErasmus University Rotterdam · NLNational University of Ireland · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Post-cardiotomy extracorporeal life support (PC-ECLS) has seen a substantial increase in use over the past 10 years. PC-ECLS can be a life-saving procedure and is mostly applied in the presence of unexpected, severe cardio-respiratory complication. Despite PC-ECLS being critical in allowing for organ recovery, it is unfortunately closely connected with an unpredictable outcomes, high morbidity, and, even in the case of cardiac function improvement, potential sustained disabilities that have a life-changing impact for the patient and his or her family. Since the decision to start PC-ECLS is made in an acute setting, there is often only limited or no time for self-determined choices. Due to the major impact of the intervention, it would be highly desirable to obtain informed consent before starting PC-ECLS, since the autonomy of the patient and shared-decision making are two of the most important ethical values in modern medicine. Recent developments regarding awareness of the impacts of a prolonged intensive care stay make this a particularly relevant topic. Therefore, it would be desirable to develop a structural strategy that takes into account the likelihood of such an intervention and the wishes and preferences of the patient, and thus the related autonomy of the patient. This article proposes key points for such a strategy in the form of a PC-ECLS informed consent, a do-(not-)mechanical-circulatory-support order (D(N)MCS), and specific guidelines to determine the extent of the shared decision making. The concept presented in this article could be a starting point for improved and ethical PC-ECLS treatment and application.

Indexed as

D(N)MCSdo-(not-)mechanical-circulatory-supportELSethicsextracorporeal life supportPC-ECLSpost-cardiotomy extracorporeal life support

Identifiers

PMID33498412
PMCPMC7864157
OpenAlexW3121714194

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.