ArticleThe American journal of hospice & palliative care2022
Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice.
Article in The American journal of hospice & palliative care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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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.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Extracorporeal Life Support in Severe Accidental Hypothermia: Mechanisms, Challenges and Clinical Horizons.Journal of clinical medicine · 2026Review
- Clinician Perspectives on the Extracorporeal Membrane Oxygenation Decision-Making Process.JAMA network open · 2026Article
- Challenges of ECMO use for severe trauma: a narrative review.Hereditas · 2025Review
- Cardiovascular Physiology During Mechanical Circulatory Support: Implications for Management and Monitoring.Journal of clinical medicine · 2025Review
- [Ethical aspects in the context of extracorporeal life support systems (ECLS): consensus paper of the DGK, DGTHG and DGAI].Die Anaesthesiologie · 2024Review
- Web-based Dashboard on ECMO Utilization in Germany: An Interactive Visualization, Analyses, and Prediction Based on Real-life Data.Journal of medical systems · 2024Article
- Exercising medical judgement: resuscitation and "Decision-Making for End-of-Life Care," a new policy from the College of Physician and Surgeons of Ontario.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Review
- [Extracorporeal life support (ECLS): 2021 update].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2022Article
- Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda.Frontiers in pediatrics · 2022Article
- Ethics of Extracorporeal Membrane Oxygenation under Conventional and Crisis Standards of Care.The Journal of clinical ethics · 2022Article
Corrections and comments
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Authors and funding
11 authors at 7 institutions in 1 country.
Funding
Abstract
purposeExtracorporeal membrane oxygenation (ECMO) is an expensive and scarce life sustaining treatment provided to certain critically ill patients. Little is known about the informed consent process for ECMO or clinician viewpoints on ethical complexities related to ECMO in practice.
methodsWe sent a cross-sectional survey to all departments providing ECMO within 7 United States hospitals in January 2021. One clinician from each department completed the 42-item survey representing their department.
resultsFourteen departments within 7 hospitals responded (response rate 78%, N = 14/18). The mean time spent consenting patients or surrogate decision-makers for ECMO varied, from 7.5 minutes (95% CI 5-10) for unstable patients to 20 minutes (95% CI 15-30) for stable patients (p = 0.0001). Few clinician respondents (29%) report patients or surrogate decision-makers always possess informed consent for ECMO. Most departments (92%) have absolute exclusion criteria for ECMO such as older age (43%, cutoffs ranging from 60-75 years), active malignancy (36%), and elevated body mass index (29%). A significant minority of departments (29%) do not always offer the option to withdraw ECMO to patients or surrogate decision-makers. For patients who cannot be liberated from ECMO and are ineligible for heart or lung transplant, 36% of departments would recommend the patient be removed from ECMO and 64% would continue ECMO support.
conclusionAdequate informed consent for ECMO is a major ethical challenge, and the content of these discussions varies. Use of categorical exclusion criteria and withdrawal of ECMO if a patient cannot be liberated from it differ among departments and institutions.
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Registered trials
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.