Role of extracorporeal cardiopulmonary resuscitation in adults

Acute and Critical Care
Hongsun Kim, Yang Hyun Cho

Abstract

Extracorporeal cardiopulmonary resuscitation (ECPR) has been performed with increasing frequency worldwide to improve the low survival rate of conventional cardiopulmonary resuscitation (CCPR). Several studies have shown that among patients who experience in-hospital cardiac arrest, better survival outcomes and neurological outcomes can be expected after ECPR than after CCPR. However, studies have not clearly shown a short-term survival benefit of ECPR for patients who experience out-of-hospital cardiac arrest. Favorable outcomes are associated with a shorter low-flow time, an initial shockable rhythm, lower serum lactate levels, higher blood pH, and a lower Sequential Organ Failure Assessment score. Indications for ECPR include young age, witnessed arrest with bystander cardiopulmonary resuscitation, an initial shockable rhythm, correctable causes such as a cardiac etiology, and no return of spontaneous circulation within 10-20 minutes of CCPR. ECPR is a complex intervention that requires a highly trained team, specialized equipment, and multidisciplinary support within a healthcare system, and it has the risk of several life-threatening complications. Therefore, physicians should carefully select patients for ECPR who can gai...Continue Reading

References

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Apr 15, 2019·The Annals of Thoracic Surgery·Jeong-Am RyuJeong Hoon Yang

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Citations

Aug 31, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Tang ZhangHao Liu
Sep 14, 2020·The Korean Journal of Thoracic and Cardiovascular Surgery·Seong Soon KwonYoung Woo Park
May 17, 2021·Journal of Cardiac Surgery·Ilija Djordjevic, Thorsten Wahlers
Jul 24, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Young Su KimKiick Sung
Sep 14, 2021·Artificial Organs·Christopher GaisendreesThorsten Wahlers

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Clinical Trials Mentioned

NCT03101787
NCT03880565
NCT01511666

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