Enhancing cardiac arrest survival with extracorporeal cardiopulmonary resuscitation: insights into the process of death

被引：11

作者：

Aufderheide, Tom P. ^{[1
]}

Kalra, Rajat ^{[2
,3
]}

Kosmopoulos, Marinos ^{[2
]}

Bartos, Jason A. ^{[2
,3
]}

Yannopoulos, Demetris ^{[2
,3
]}

机构：

[1] Med Coll Wisconsin, Dept Emergency Med, HUB Collaborat Med, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA

[2] Univ Minnesota, Sch Med, Ctr Resuscitat Med, Minneapolis, MN 55455 USA

[3] Univ Minnesota, Div Cardiovasc, Minneapolis, MN 55455 USA

来源：

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES | 2022年 / 1507卷 / 01期

关键词：

cardiopulmonary resuscitation; extracorporeal cardiopulmonary resuscitation; extracorporeal membrane oxygenation; neurological recovery; neurological prognostication; brain death; CORONARY PERFUSION-PRESSURE; IMPEDANCE THRESHOLD DEVICE; CEREBRAL-BLOOD-FLOW; LIFE-SUPPORT; PORCINE MODEL; MEMBRANE-OXYGENATION; SPONTANEOUS CIRCULATION; PROGNOSTIC VALUE; THERAPEUTIC HYPOTHERMIA; CLINICAL-EVALUATION;

D O I：

10.1111/nyas.14580

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging method of cardiopulmonary resuscitation to improve outcomes from cardiac arrest. This approach targets patients with out-of-hospital cardiac arrest previously unresponsive and refractory to standard treatment, combining approximately 1 h of standard CPR followed by venoarterial extracorporeal membrane oxygenation (VA-ECMO) and coronary artery revascularization. Despite its relatively new emergence for the treatment of cardiac arrest, the approach is grounded in a vast body of preclinical and clinical data that demonstrate significantly improved survival and neurological outcomes despite unprecedented, prolonged periods of CPR. In this review, we detail the principles behind VA-ECMO-facilitated resuscitation, contemporary clinical approaches with outcomes, and address the emerging new understanding of the process of death and capability for neurological recovery.

引用

页码：37 / 48

页数：12

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