Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: an overview of current practice and evidence.

Autor: Ali S; Department of Intensive Care, Erasmus University Medical Centre, Rotterdam, The Netherlands. s.ali@erasmusmc.nl.; Department of Anaesthesiology, Erasmus Medical Centre, Rotterdam, The Netherlands. s.ali@erasmusmc.nl.; Ministry of Defence, Royal Netherlands Air Force, Breda, The Netherlands. s.ali@erasmusmc.nl., Meuwese CL; Department of Intensive Care, Erasmus University Medical Centre, Rotterdam, The Netherlands.; Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Moors XJR; Department of Anaesthesiology, Erasmus Medical Centre, Rotterdam, The Netherlands.; Helicopter Emergency Medical Services, Trauma Centre Zuid-West Nederland, Erasmus University Medical Centre, Rotterdam, The Netherlands., Donker DW; Cardiovascular and Respiratory Physiology, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.; Department of Intensive Care, University Medical Centre Utrecht, Utrecht, The Netherlands., van de Koolwijk AF; Department of Intensive Care, Maastricht University Medical Centre, Maastricht, The Netherlands., van de Poll MCG; Department of Intensive Care, Maastricht University Medical Centre, Maastricht, The Netherlands., Gommers D; Department of Intensive Care, Erasmus University Medical Centre, Rotterdam, The Netherlands., Dos Reis Miranda D; Department of Intensive Care, Erasmus University Medical Centre, Rotterdam, The Netherlands.; Helicopter Emergency Medical Services, Trauma Centre Zuid-West Nederland, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation [Neth Heart J] 2024 Apr; Vol. 32 (4), pp. 148-155. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1007/s12471-023-01853-5
Abstrakt: Cardiac arrest (CA) is a common and potentially avoidable cause of death, while constituting a substantial public health burden. Although survival rates for out-of-hospital cardiac arrest (OHCA) have improved in recent decades, the prognosis for refractory OHCA remains poor. The use of veno-arterial extracorporeal membrane oxygenation during cardiopulmonary resuscitation (ECPR) is increasingly being considered to support rescue measures when conventional cardiopulmonary resuscitation (CPR) fails. ECPR enables immediate haemodynamic and respiratory stabilisation of patients with CA who are refractory to conventional CPR and thereby reduces the low-flow time, promoting favourable neurological outcomes. In the case of refractory OHCA, multiple studies have shown beneficial effects in specific patient categories. However, ECPR might be more effective if it is implemented in the pre-hospital setting to reduce the low-flow time, thereby limiting permanent brain damage. The ongoing ON-SCENE trial might provide a definitive answer regarding the effectiveness of ECPR. The aim of this narrative review is to present the most recent literature available on ECPR and its current developments.
(© 2024. The Author(s).)
Databáze: MEDLINE
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