Implementing enhanced extracorporeal membrane oxygenation for CPR (ECPR) in the emergency department

被引：1

作者：

Oliver, Matthew ^{[1
,2
,3
]}

Coggins, Andrew ^{[2
,4
]}

Kruit, Natalie ^{[2
,5
,6
,10
]}

Burns, Brian ^{[2
,6
]}

Plunkett, Brian ^{[7
]}

Morgan, Steve ^{[8
]}

Southwood, Tim J. ^{[9
]}

Totaro, Richard ^{[9
]}

Forrest, Paul ^{[10
]}

Russell, Saartje Berendsen ^{[1
,3
]}

Carey, Ruaidhri ^{[9
]}

Dennis, Mark ^{[2
,11
]}

机构：

[1] Royal Prince Alfred Hosp, Dept Emergency Med, Sydney, NSW, Australia

[2] Univ Sydney, Med Sch, Sydney, Australia

[3] Royal Prince Alfred Hosp, Greenlight Inst Emergency Care, Sydney, Australia

[4] Westmead Hosp, Dept Emergency Med, Sydney, NSW, Australia

[5] Westmead Hosp, Dept Anaesthesia, Sydney, NSW, Australia

[6] New South Wales Ambulance, Aeromed Retrieval Serv, Sydney, Australia

[7] Royal Prince Alfred Hosp, Dept Cardiothorac Surg, Sydney, NSW, Australia

[8] St Vincents Hosp, Dept Intens Care, Sydney, NSW, Australia

[9] Royal Prince Alfred Hosp, Dept Intens Care, Sydney, NSW, Australia

[10] Royal Prince Alfred Hosp, Dept Anaesthesia, Sydney, NSW, Australia

[11] Royal Prince Alfred Hosp, Dept Cardiol, Sydney, Australia

来源：

INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE | 2024年 / 17卷 / 01期

关键词：

ECMO; ECPR; Cardiac; Arrest; Resuscitation; HOSPITAL CARDIAC-ARREST; CONVENTIONAL CARDIOPULMONARY-RESUSCITATION; REFRACTORY VENTRICULAR-FIBRILLATION; SINGLE-CENTER; CARE; REPERFUSION; REGISTRY;

D O I：

10.1186/s12245-024-00652-y

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge. The best outcomes for ECPR occur when the time from cardiac arrest to implementation of ECPR is minimised. To reduce this time, systems must be in place to identify the correct patient, expedite transfer to hospital, facilitate rapid cannulation and ECMO circuit flows. We describe the process of activation of ECPR, patient selection, and the steps that emergency department clinicians can utilise to facilitate timely cannulation to ensure the best outcomes for patients in refractory cardiac arrest. With these processes in place our survival to hospital discharge for OHCA patients is 35%, with most patients having a good neurological function.

引用

页数：9

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