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              <text>&lt;a href="http://doi.org/10.3389/fped.2022.896232" target="_blank" rel="noreferrer noopener"&gt;http://doi.org/10.3389/fped.2022.896232&lt;/a&gt;</text>
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                <text>Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda</text>
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                <text>Clark  JD; Baden  HP; Berkman  ER; Bourget  E; Brogan  TV; Di Gennaro  JL; Doorenbos  AZ; McMullan  DM; Roberts  JS; Turnbull  JM; Wilfond  BS; Lewis-Newby  M</text>
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                <text>Technological advancements and rapid expansion in the clinical use of extracorporeal life support (ECLS) across all age ranges in the last decade, including during the COVID-19 pandemic, has led to important ethical considerations. As a costly and resource intensive therapy, ECLS is used emergently under high stakes circumstances where there is often prognostic uncertainty and risk for serious complications. To develop a research agenda to further characterize and address these ethical dilemmas, a working group of specialists in ECLS, critical care, cardiothoracic surgery, palliative care, and bioethics convened at a single pediatric academic institution over the course of 18 months. Using an iterative consensus process, research questions were selected based on: (1) frequency, (2) uniqueness to ECLS, (3) urgency, (4) feasibility to study, and (5) potential to improve patient care. Questions were categorized into broad domains of societal decision-making, bedside decision-making, patient and family communication, medical team dynamics, and research design and implementation. A deeper exploration of these ethical dilemmas through formalized research and deliberation may improve equitable access and quality of ECLS-related medical care.</text>
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