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ECPR2: Expert Consensus on PeRcutaneous Cannulation for Extracorporeal CardioPulmonary Resuscitation
Florian F Schmitzberger1, Nathan L Haas2, Ryan A Coute3
1Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
Resuscitation
|July 11, 2022
Summary
Extracorporeal cardiopulmonary resuscitation (ECPR) best practices for out-of-hospital cardiac arrest (OHCA) were established using a Delphi process. This consensus provides a framework for ECPR initiation in adult non-traumatic OHCA patients.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care Medicine
Background:
- Extracorporeal cardiopulmonary resuscitation (ECPR) is a vital intervention for refractory out-of-hospital cardiac arrest (OHCA).
- Optimal ECPR initiation protocols following OHCA remain incompletely defined.
- Limited data exist on best practices for ECPR initiation after OHCA.
Purpose of the Study:
- To systematically identify and define best practices for ECPR initiation in adult non-traumatic OHCA.
- To establish consensus among international experts on critical ECPR initiation steps.
- To provide a standardized framework for ECPR programs.
Main Methods:
- A modified Delphi process involving two survey rounds and a virtual consensus meeting was employed.
- Snowball sampling identified a panel of 14 international content experts from diverse specialties.
- Consensus was defined as >80% agreement on a 5-point Likert scale (rated 4 or 5).
Main Results:
- A comprehensive list of 101 consensus items for ECPR initiation was generated.
- Key areas included: Prior to Patient Arrival (13 items), Inclusion Criteria (8), Exclusion Criteria (7), Patient Arrival (8), ECPR Cannulation (21), Go On Pump (18), and Post-Cannulation (26).
- The consensus covered critical aspects from pre-arrival preparation to post-cannulation management.
Conclusions:
- This study presents expert-derived best practices for initiating ECPR in adult non-traumatic OHCA.
- The findings offer a valuable resource for quality assurance in existing ECPR programs.
- The consensus list can serve as a template for developing new ECPR initiatives.
