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Extracorporeal membrane oxygenation for refractory cardiac arrest
Steven A Conrad1, Peter T Rycus2
1Division of Critical Care Medicine, Louisiana State University Health Sciences Center; University Health Shreveport, Extracorporeal Life Support Program, Shreveport, Louisiana, USA.
Annals of Cardiac Anaesthesia
|January 12, 2017
Summary
Extracorporeal cardiopulmonary resuscitation (ECPR) offers improved outcomes for cardiac arrest patients unresponsive to conventional CPR, especially when initiated within 30-60 minutes. This advanced technique supports circulation and organ perfusion, making it a viable option in specialized centers.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care
Background:
- Refractory cardiac arrest requires advanced life support beyond conventional cardiopulmonary resuscitation (CPR).
- Extracorporeal membrane oxygenation (ECMO) offers a potential solution for systemic support during cardiac arrest.
Purpose of the Study:
- To define Extracorporeal cardiopulmonary resuscitation (ECPR) and its role in managing refractory cardiac arrest.
- To outline patient selection criteria and deployment considerations for ECPR.
Main Methods:
- ECPR utilizes rapid deployment venoarterial (VA) ECMO to support circulation and organ perfusion.
- Percutaneous cannulation is feasible and can be performed by various non-surgical specialists.
- Modern extracorporeal systems are user-friendly with appropriate training.
Main Results:
- Observational studies suggest improved outcomes with ECPR compared to conventional CPR when initiated within 30-60 minutes.
- ECPR is indicated for patients with witnessed arrest, failed conventional resuscitation, and potentially reversible causes.
Conclusions:
- ECPR is a valuable intervention for refractory cardiac arrest in centers with established extracorporeal life support programs.
- Consideration of ECPR requires resources for rapid deployment and post-resuscitation care.
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