• Dtsch Arztebl Int · Oct 2023

    Review

    Extracorporeal Cardiopulmonary Resuscitation—Evidence and Implications.

    • Christopher Gaisendrees, Jan-Steffen Pooth, Maximilian Luehr, Anton Sabashnikov, Demetris Yannopoulos, and Thorsten Wahlers.
    • Department of Cardiac Surgery, Intensive Care Medicine and Thoracic Surgery, University Hospital Cologne, Cologne, Germany; Center for Resuscitation Medicine, University of Minnesota, Minneapolis, USA; Emergency Department (UNZ), Medical Center - University of Freiburg, Medical Faculty, Freiburg, Germany.
    • Dtsch Arztebl Int. 2023 Oct 20; 120 (42): 703710703-710.

    BackgroundAround 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).MethodsA 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.ResultsOut 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.ConclusionECPR 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.

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