Objective: 

To describe current hospital guidelines and the opinions of extracorporeal membrane oxygenation leaders at U.S. children’s hospitals concerning the use of extracorporeal membrane oxygenation for coronavirus disease 2019–positive pediatric patients.

Design: 

Confidential, self-administered questionnaire.

Setting: 

One hundred twenty-seven U.S. pediatric extracorporeal membrane oxygenation centers.

Subjects: 

Extracorporeal membrane oxygenation center program directors and coordinators.

Interventions: 

None.

Measurements and Main Results: 

In March 2020, a survey was sent to 127 pediatric extracorporeal membrane oxygenation centers asking them to report their current hospital extracorporeal membrane oxygenation guidelines for coronavirus disease 2019–positive patients. Respondents were also asked their opinion on three ethical dilemmas including: prioritization of children over adults for extracorporeal membrane oxygenation use, institution of do-not-resuscitate orders, and the use of extracorporeal cardiopulmonary resuscitation for coronavirus disease 2019–positive patients. Forty-seven extracorporeal membrane oxygenation centers had enacted guidelines including 46 (100%) that offer venovenous-extracorporeal membrane oxygenation and 42 (89%) that offer venoarterial-extracorporeal membrane oxygenation for coronavirus disease 2019–positive pediatric patients. Forty-four centers (94%) stated that the indications for extracorporeal membrane oxygenation candidacy in coronavirus disease 2019 disease were similar to those used in other viral illnesses, such as respiratory syncytial virus or influenza. Most program directors (98%) did not endorse that children hospitalized with coronavirus disease 2019 should be made do-not-resuscitate and had variable opinions on whether children should be given higher priority over adults when rationing extracorporeal membrane oxygenation. Over half of program directors (60%) did not support the use of extracorporeal cardiopulmonary resuscitation for coronavirus disease 2019.

Conclusions: 

The majority of pediatric extracorporeal membrane oxygenation centers have proactively established guidelines for the use of extracorporeal membrane oxygenation for coronavirus disease 2019–related illnesses. Further work is needed to help guide the fair allocation of extracorporeal membrane oxygenation resources and to determine the appropriateness of extracorporeal cardiopulmonary resuscitation.

中文翻译：

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患有 2019 年冠状病毒病相关疾病的儿科患者的体外膜氧合。

 客观的：

描述当前的医院指南以及美国儿童医院体外膜肺氧合领导者关于对2019 年冠状病毒病阳性儿科患者使用体外膜肺氧合的意见。

 设计：

保密、自我管理的调查问卷。

 环境：

美国有一百二十七个儿科体外膜肺氧合中心。

 科目：

体外膜氧合中心项目主任和协调员。

 干预措施：

 没有任何。

测量和主要结果：

2020 年 3 月，向 127 个儿科体外膜氧合中心发送了一项调查，要求他们报告当前医院针对2019 年冠状病毒病阳性患者的体外膜氧合指南。受访者还被问及对三个道德困境的看法，包括：优先考虑儿童而不是成人使用体外膜氧合、制定不复苏令以及对2019 年冠状病毒病阳性患者使用体外心肺复苏。 47个体外膜氧合中心已制定指南，其中 46 个（100%）中心为2019 年冠状病毒病阳性儿科患者提供静脉-体外膜氧合中心，42 个（89%）中心提供静脉-动脉-体外膜氧合中心。 44 个中心 (94%) 表示， 2019 年冠状病毒病的体外膜肺氧合候选适应症与呼吸道合胞病毒或流感等其他病毒性疾病中使用的适应症相似。大多数项目负责人 (98%) 不赞成对因2019 年冠状病毒病住院的儿童进行不进行复苏，并且对于在配给体外膜氧合时是否应优先考虑儿童而不是成人持有不同意见。 超过一半的项目负责人 (60%) 不支持对2019 年冠状病毒病使用体外心肺复苏术。

 结论：

大多数儿科体外膜氧合中心已主动制定了使用体外膜氧合治疗2019 年冠状病毒病相关疾病的指南。需要进一步的工作来帮助指导体外膜氧合资源的公平分配并确定体外心肺复苏的适当性。