[体外生命支持系统(ECLS)的伦理问题:DGK、DGTHG 和 DGAI 的共识文件]。

Jochen Dutzmann, Hanno Grahn, Udo Boeken, Christian Jung, Andrej Michalsen, Gunnar Duttge, Ralf Muellenbach, P Christian Schulze, Lars Eckardt, Georg Trummer, Guido Michels
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摘要

体外生命支持系统(ECLS)是维持严重心血管疾病患者生命的措施,在心血管功能恢复或进行心脏移植或植入永久性心室辅助装置等替代治疗之前,可作为桥接治疗。由于证据不足,而且经常在未征得患者初步同意的情况下紧急植入,这给患者、亲属和跨专业重症监护团队带来了巨大的伦理挑战和心理负担。与任何治疗方法一样,必须根据适应症和患者的知情同意为 ECLS 治疗制定适当的治疗目标。为了将必要的伦理考虑纳入日常临床实践,本文提出了一种处理 ECLS 的结构化算法,其中充分考虑到了伦理方面的问题。
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[Ethical aspects in the context of extracorporeal life support systems (ECLS): consensus paper of the DGK, DGTHG and DGAI].

Extracorporeal life support systems (ECLS) are life-sustaining measures for severe cardiovascular diseases, serving as bridging treatment either until cardiovascular function is restored or alternative treatment, such as heart transplantation or the implantation of permanent ventricular assist devices is performed. Given the insufficient evidence and frequent urgency of implantation without initial patient consent, the ethical challenges and psychological burden for patients, relatives and the interprofessional intensive care team are significant. As with any treatment, an appropriate therapeutic goal for ECLS treatment based on the indications and patient informed consent is mandatory. In order to integrate the necessary ethical considerations into everyday clinical practice, a structured algorithm for handling ECLS is proposed here, which takes ethical aspects into due account.

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