[The Use of ECMO for Cardiopulmonary Resuscitation (ECPR) and the Attempt to Modify Resuscitation Outcomes]

In recent decades, considerable efforts have been invested in improving the survival of patients undergoing cardiopulmonary resuscitation (CPR). Despite these advances, overall survival rates following out-of-hospital cardiac arrest (OHCA) remain low, and survival with intact or near-intact neurological function is even lower. The use of extracorporeal membrane oxygenation (ECMO) during resuscitation is intended to rapidly restore perfusion to vital organs, most importantly the brain, thereby providing the medical team with valuable time to initiate definitive treatment while limiting ongoing tissue injury. In recent years, leading medical centers worldwide have begun publishing their results with this technique, and several studies have contributed to a better understanding of both its potential and its challenges. Incorporating ECMO into resuscitation (eCPR) has the potential to substantially reduce, or even prevent, the deleterious consequences of prolonged CPR, particularly when cannulation is achieved rapidly. However, its application requires extensive logistical preparation, close coordination among multidisciplinary teams, a very high level of expertise, and considerable resources. In Israel, several centers have begun implementing this approach, and local experience continues to accumulate. This article describes the Shaare Zedek Medical Center's experience, details the implementation and refinement process, and highlights additional topics for future discussion.