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.
Bibliographical noteFunding Information:
All authors (T.P.A., R.K., M.K., J.A.B., and D.Y.) have made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; participated in drafting the manuscript or revising its intellectual con- tent; approved the final version of the submitted manuscript; and accepted responsibility for the integrity of the data analyzed. All authors report having received research grants from the National Heart, Lung, and Blood Institute, and the Leona M. and Harry B. Helmsley Charitable Trust.
© 2021 New York Academy of Sciences.
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't