24, 74, 77
Seven and a half minutes is the consent figure for a patient who is merely unstable; in ECPR it is zero. And on the single question of what to do with a bridge to nowhere, ECMO departments divide roughly one to two - which is why the authority to stop must be settled as programme policy before a case arises rather than negotiated during one.
Stable against unstable patients; departments against each other
DOI 10.1177/10499091211041079
Cross-sectional survey of consent practice and of what departments would do for a patient who cannot be liberated from ECMO
14 departments, one country, one respondent per department representing the whole department. Structured abstract only. [VERIFICATION REQUIRED]
Mean consent time 7.5 minutes (95% CI 5-10) for unstable patients against 20 minutes (15-30) for stable patients (P = 0.0001). Only 29% reported that patients or surrogates always possess informed consent for ECMO. 92% have absolute exclusion criteria - older age 43% (cut-offs 60 to 75 years), active malignancy 36%, elevated body mass index 29%. 29% do not always offer the option of withdrawing ECMO. For a patient who cannot be liberated and is ineligible for heart or lung transplant, 36% of departments would recommend removal from ECMO and 64% would continue.
14 departments providing ECMO across 7 United States hospitals, surveyed January 2021 (response rate 78%)