Table 1 Priority topics and corresponding PICOs
No. | Topic | Population | Intervention | Control | Outcome | Sub-topics |
|---|---|---|---|---|---|---|
1 | Cardiogenic shock: definition, degree and timing of cardiogenic shock as VA-ECMO indication | Patients suffering cardiogenic shock1 | Early in course | Refractory cardiogenic shock | Shock reversal, in-hospital mortality | – |
2 | Selection criteria for ECPR | Patients suffering cardiac arrest | ECPR (VA-ECMO) | Conventional cardiopulmonary resuscitation | In-hospital mortality, length-of-stay | Patient age Time-to-ECMO Location of insertion: in-hospital/on-site |
3 | ECMO connecting: percutaneous versus surgical methods | Patients undergoing cannulation for VA-ECMO | Percutaneous cannulation | Surgical cannulation | Hemorrhage, in-hospital mortality | – |
4 | Monitoring: daily therapy goals | Patients supported with VA-ECMO | Daily goals | Standard care | In-hospital mortality | Fluid balance, min/max Reducing blood flow Reducing sedatives |
5 | Monitoring: optimal balance of blood pressure & vasoactive medication | Patients supported with VA-ECMO | Accepting a lower MAP (< 65 mmHg) | Standard MAP (≥ 65 mmHg) | In-hospital mortality | – |
6 | Blood transfusion regimen | Patients supported with VA-ECMO | Restrictive regimen (dependent of blood product) | Liberal regimen (dependent of blood product) | In-hospital mortality | Red blood cells Platelets Plasma |
7 | Anticoagulant therapies | Patients supported with VA-ECMO | Non-heparin anticoagulant therapy | Continuous systemic heparin | In-hospital mortality | LMWH Bivalirudin DTIs |
8 | Complications: endothelial activation and damage | Patients supported with VA-ECMO | Monitoring endothelial damage and activation markers | No additional markers/monitoring | In-hospital mortality | ICAM-1 VCAM Syndecam-1 |