Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: an overview of current practice and evidence

Samir Ali*, Christiaan L. Meuwese, Xavier J.R. Moors, Dirk W. Donker, Anina F. van de Koolwijk, Marcel C.G. van de Poll, Diederik Gommers, Dinis Dos Reis Miranda

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademic

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Cardiac arrest (CA) is a common and potentially avoidable cause of death, while constituting a substantial public health burden. Although survival rates for out-of-hospital cardiac arrest (OHCA) have improved in recent decades, the prognosis for refractory OHCA remains poor. The use of veno-arterial extracorporeal membrane oxygenation during cardiopulmonary resuscitation (ECPR) is increasingly being considered to support rescue measures when conventional cardiopulmonary resuscitation (CPR) fails. ECPR enables immediate haemodynamic and respiratory stabilisation of patients with CA who are refractory to conventional CPR and thereby reduces the low-flow time, promoting favourable neurological outcomes. In the case of refractory OHCA, multiple studies have shown beneficial effects in specific patient categories. However, ECPR might be more effective if it is implemented in the pre-hospital setting to reduce the low-flow time, thereby limiting permanent brain damage. The ongoing ON-SCENE trial might provide a definitive answer regarding the effectiveness of ECPR. The aim of this narrative review is to present the most recent literature available on ECPR and its current developments.

Original languageEnglish
Pages (from-to)148-155
Number of pages8
JournalNetherlands Heart Journal
Issue number4
Publication statusPublished - Apr 2024

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