Extracorporeal CPR: Now a standard of care?

Scquizzato T, Bernard SA.
Resusc Plus. 2022 Apr 21;10:100235. doi: 10.1016/j.resplu.2022.100235. eCollection 2022 Jun.
PMID: 35493292


Despite significant improvements in the field of resuscitation, overall survival after out-of-hospital cardiac arrest (OHCA) remains low [1,2], and many survivors have persistent neurological damage. Refractory OHCA, defined as the failure to achieve return of spontaneous circulation (ROSC) despite conventional cardiopulmonary resuscitation (CPR), is associated with an even worse prognosis. In fact, after ten minutes of conventional cardiopulmonary CPR, chances of survival start to decline rapidly [3]. After 35 minutes, less than 1% of patients achieve ROSC and survive with a favourable neurological outcome [4,5].

One of the most recent interventions applied and investigated in the resuscitation of patients with OHCA is extracorporeal membrane oxygenation (ECMO). Extracorporeal CPR (E-CPR), the rapid deployment of veno-arterial ECMO during ongoing CPR, is a promising approach for patients with refractory OHCA [6]. Evidence supporting E-CPR is now compelling. After many observational studies [7–13], two randomised trials demonstrated the feasibility and possible benefits of early transport to the hospital for initiation of E-CPR in patients with refractory OHCA [14,15]. In addition, a recent meta-analysis showed an improved rate of survival with good neurological outcomes [16].

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Scquizzato T, Bernard SA. Extracorporeal CPR: Now a standard of care?. Resusc Plus. 2022;10:100235. Published 2022 Apr 21. doi:10.1016/j.resplu.2022.100235

Tommaso Scquizzato
Tommaso Scquizzato

Tommaso Scquizzato is a researcher in the fields of cardiac arrest and resuscitation science at the Center for Intensive Care and Anesthesiology of San Raffaele Hospital in Milan, Italy. He is the Social Media Editor of Resuscitation, member of the Social Media Working Group of ILCOR, and member of the ERC BLS Science and Education Committee.

Articles: 35

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