Extracorporeal Cardiopulmonary Resuscitation: A Narrative Review and Establishment of a Sustainable Program.
Chris M CassaraMicah T LongJohn T DollerschellFloria ChaeDavid J HallGozde DemiralpMatthew J StampflBrittney BernardoniDaniel P McCarthyJoshua M GlazerPublished in: Medicina (Kaunas, Lithuania) (2022)
The rates of survival with functional recovery for out of hospital cardiac arrest remain unacceptably low. Extracorporeal cardiopulmonary resuscitation (ECPR) quickly resolves the low-flow state of conventional cardiopulmonary resuscitation (CCPR) providing valuable perfusion to end organs. Observational studies have shown an association with the use of ECPR and improved survivability. Two recent randomized controlled studies have demonstrated improved survival with functional neurologic recovery when compared to CCPR. Substantial resources and coordination amongst different specialties and departments are crucial for the successful implementation of ECPR. Standardized protocols, simulation based training, and constant communication are invaluable to the sustainability of a program. Currently there is no standardized protocol for the post-cannulation management of these ECPR patients and, ideally, upcoming studies should aim to evaluate these protocols.
Keyphrases
- cardiopulmonary resuscitation
- cardiac arrest
- quality improvement
- end stage renal disease
- ejection fraction
- newly diagnosed
- randomized controlled trial
- primary care
- peritoneal dialysis
- prognostic factors
- double blind
- open label
- extracorporeal membrane oxygenation
- free survival
- clinical trial
- ultrasound guided
- magnetic resonance
- phase ii