Dataset Information

[ECMO support during the first two waves of the corona pandemic-a survey of high case volume centers in Germany].

ABSTRACT:

Background

At the onset of the coronavirus pandemic, concerns were raised about sufficiency of available intensive care resources. In many places, routine interventions were postponed and criteria for the allocation of scarce resources were formulated. In Germany, some hospitals were at times seriously burdened during the course of the pandemic. Intensive care units in particular experienced a shortage of resources, which may have led to a restriction of services and a stricter indication setting for resource-intensive measures such as extracorporeal membrane oxygenation (ECMO). The aim of this work is to provide an overview of how these pressures were managed at large ECMO centers in Germany.

Methods

One representative of each major ECMO referral center in Germany was invited to participate in an online survey in spring 2021.

Results

Of 34 invitations that were sent out, the survey was answered by 23 participants. In all centers, routine procedures were postponed during the pandemic. Half of the centers increased the number of beds on which ECMO procedures could be offered. Nevertheless, in one-third of the centers, the start of at least one ECMO support was delayed because of a feared resource shortage. In 17% of centers, at least one patient was denied ECMO that he or she would have most likely received under prepandemic conditions.

Conclusion

The results of this online survey indicate that the experienced pressures and resource constraints led some centers to be cautious about ECMO indications.

SUBMITTER: Supady A

PROVIDER: S-EPMC9453733 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

[ECMO support during the first two waves of the corona pandemic-a survey of high case volume centers in Germany].

Supady Alexander A Michels Guido G Lepper Philipp M PM Ferrari Markus M Wippermann Jens J Sabashnikov Anton A Thiele Holger H Hennersdorf Marcus M Lahmer Tobias T Boeken Udo U Gummert Jan J Tigges Eike E Muellenbach Ralf M RM Spangenberg Tobias T Wengenmayer Tobias T Staudacher Dawid L DL

Medizinische Klinik, Intensivmedizin und Notfallmedizin 20220908 6

<h4>Background</h4>At the onset of the coronavirus pandemic, concerns were raised about sufficiency of available intensive care resources. In many places, routine interventions were postponed and criteria for the allocation of scarce resources were formulated. In Germany, some hospitals were at times seriously burdened during the course of the pandemic. Intensive care units in particular experienced a shortage of resources, which may have led to a restriction of services and a stricter indicatio ...[more]

PMID: 36074153

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Project description:BackgroundWilson disease (WD) is a rare, hereditary disorder of copper metabolism. Due to its variable symptoms and manifestations, diagnosis remains challenging. Affected patients must obtain lifelong medical treatment, as the disease is fatal if untreated. Patients require continuous monitoring, but little is known about the care of these patients in Germany. Therefore, we analyzed the medical care of WD patients at German university centers. We sent a questionnaire containing 20 questions to a total of 108 departments of pediatrics, neurology and gastroenterology in 36 university hospitals. Our questions referred to the characteristics of WD patients at the different sites and internal procedures regarding diagnosis, therapy and follow-up. A descriptive statistical analysis was performed.ResultsSixty-three departments (58%) returned our questionnaire. In total, approximately one-third of the estimated WD patients in Germany are seen annually in the outpatient clinics of these departments (approx. 950 patients). There are only a few departments which treat patients in a multidisciplinary setting (12%). Our survey revealed that for diagnosis, 51% of all departments used an algorithm based on the Leipzig score as recommended by international guidelines. Most departments apply essential parameters recommended by WD guidelines. Routine monitoring is performed at least biannually by 84% of the departments, and standard investigations for monitoring are regularly applied. A routine family screening is performed by 84% of all departments. A reduction in medical therapy during pregnancy is recommended by 46% of the departments. Only 14% suggested that WD patients should not breastfeed. Liver transplantation (LT) due to WD is a rare but repeatedly occurring event. Most departments of gastroenterology (72%) reported at least one patient with LT within the last decade.ConclusionsMedical care of WD patients at German university centers follows the recommendations set forth by international guidelines, but only a few centers treat significant numbers of patients. The surveillance of patients does not follow specified standards, but most departments adhere to the accepted guidelines. The formation of central units and networks in a multidisciplinary setting should be evaluated to improve the care of WD patients.

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Dataset Information

[ECMO support during the first two waves of the corona pandemic-a survey of high case volume centers in Germany].

Background

Methods

Results

Conclusion

Publications

[ECMO support during the first two waves of the corona pandemic-a survey of high case volume centers in Germany].

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