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- Title
Extracorporeal Cardiopulmonary Resuscitation: Evidence and Implications.
- Authors
Gaisendrees, Christopher; Pooth, Jan-Steffen; Luehr, Maximilian; Sabashnikov, Anton; Yannopoulos, Demetris; Wahlers, Thorsten
- Abstract
Background: Around the world, survival rates after cardiac arrest range between <14% for in-hospital (IHCA) and <10% for outof- hospital cardiac arrest (OHCA). This situation could potentially be improved by using extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (CPR), i.e. by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: A selective literature search of Pubmed and Embase using the searching string ((ECMO) OR (ECLS)) AND (ECPR)) was carried out in February 2023 to prepare an up-to-date review of published trials comparing the outcomes of ECPR with those of conventional CPR. Results: Out of 573 initial results, 12 studies were included in this review, among them three randomized controlled trials comparing ECPR with CPR, involving a total of 420 patients. The survival rates for ECPR ranged from 20% to 43% for OHCA and 20% to 30.4% for IHCA. Most of the publications were associated with a high degree of bias and a low level of evidence. Conclusion: ECPR can potentially improve survival rates after cardiac arrest compared to conventional CPR when used in experienced, high-volume centers in highly selected patients (young age, initial shockable rhythm, witnessed cardiac arrest, therapy-refractory high-quality CPR). No general recommendation for the use of ECPR can be issued at present.
- Subjects
CARDIOPULMONARY resuscitation; EXTRACORPOREAL membrane oxygenation; CARDIAC arrest; SURVIVAL rate
- Publication
Deutsches Ärzteblatt International, 2023, Vol 120, Issue 42, p703
- ISSN
1866-0452
- Publication type
Article
- DOI
10.3238/arztebl.m2023.0189