ABSTRACT
Extracorporeal CPR is a second line treatment for refractory cardiac arrest, as written in the latest International Guidelines. Optimal timing, patient selection, location and method of implementation vary across the world. The objective here is to present an international consensus on the pillars of an ECPR program. The major aspect the group agrees on in that ECPR should be implemented within 60 minutes of collapse. With this in mind, the program should be built according to local resources knowing that the optimal team will require pre-established specific roles with personnel dedicated to resuscitation and others to ECPR.
Subject(s)
Cardiopulmonary Resuscitation , Extracorporeal Membrane Oxygenation , International Cooperation , Out-of-Hospital Cardiac Arrest , Patient Care Team , Cardiopulmonary Resuscitation/methods , Cardiopulmonary Resuscitation/standards , Consensus , Extracorporeal Membrane Oxygenation/methods , Extracorporeal Membrane Oxygenation/standards , Humans , Out-of-Hospital Cardiac Arrest/mortality , Out-of-Hospital Cardiac Arrest/therapy , Patient Care Team/organization & administration , Patient Care Team/standards , Patient Selection , Survival Rate , Time-to-Treatment/standardsABSTRACT
BACKGROUND: Out-of-hospital cardiac arrest carries a dismal prognosis. Percutaneous extracorporeal membrane oxygenation (ECMO) has been used with success for in-hospital arrests, and some literature suggests improvement in long-term survival for out-of-hospital arrests as well. OBJECTIVES: This case highlights the use of ECMO in the emergency department. CASE REPORT: We report a case in which emergency physician-initiated ECMO was used as a bridge to definitive care in an out-of- hospital cardiac arrest in the United States. CONCLUSIONS: ECMO is a novel adjunct for patients in cardiac arrest in whom the usual advanced life support techniques have failed.