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PERSPECTIVE article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1569951
This article is part of the Research Topic Critical Care Cardiology for Cardiovascular Emergencies View all 11 articles
Diagnostic of brain death and consecutive donor management under combined circulatory support by ECMELLA therapy
Provisionally accepted
Florian Jürgen Raimann 1*
Laurent Maximilian Willems 2- 1 University Hospital Frankfurt, Department of Anesthesiology, Intensive Care Medizine and Pain Therapy, Frankfurt am Main, Germany
- 2 University Hospital Frankfurt, Deparment of Neurology, Frankfurt am Main, Germany
Background: Managing brain death determination (BDD) in potential organ donors is a challenging aspect of modern intensive care medicine. Especially in critically ill patients with implanted circulatory or left ventricular support devices, standard recommendations for BDD are often no longer applicable.Methods/Results: The available recommendations and evidence for BDD and organ procuring under ECMELLA therapy, i.e. a combined circulatory support using a veno-arterial extracorporeal membrane oxygenation (vaECMO) and an invasive left ventricular support device (Impella Ò CP), is discussed based on a clinical case. To the authors knowledge, this is the first report of a BDD under ECMELLA therapy.Although BDD in patients with multimodal invasive circulatory support such as ECMELLA therapy is demanding and time-intensive, it can still be performed safely and evidencebased. Particularly in view of the continuing low numbers of organ donors, these insights may help to facilitate organ donation in patients with combined invasive mechanical circulatory support.
Keywords: ECMO, Impella, Critical Care, cardia arrest, Intensive Care, organ donation
Received: 02 Feb 2025; Accepted: 06 Mar 2025.
Copyright: © 2025 Raimann and Willems. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Florian Jürgen Raimann, University Hospital Frankfurt, Department of Anesthesiology, Intensive Care Medizine and Pain Therapy, Frankfurt am Main, Germany
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