ECMO in the ED? An Overview of ECPR

In this episode we discuss the basics of ECPR and VA-ECMO. Included is a case review and discussion. Later in the episode we outline some landmark ECPR studies, and review inclusion and exclusion criteria.

Bartos, J. A., Grunau, B., Carlson, C., Duval, S., Ripeckyj, A., Kalra, R., Raveendran, G., John, R., Conterato, M., Frascone, R. J., Trembley, A., Aufderheide, T. P., & Yannopoulos, D. (2020). Improved survival with extracorporeal cardiopulmonary resuscitation despite progressive metabolic derangement associated with prolonged resuscitation. Circulation, 141(11), 877–886. https://doi.org/10.1161/CIRCULATIONAHA.119.042173

Richardson, A. C., Tonna, J. E., Nanjayya, V., Abrams, D., Brodie, D., Pellegrino, V. A., Shekar, K., & Thiagarajan, R. R. (2021). Extracorporeal cardiopulmonary resuscitation in adults: Interim guideline consensus statement from the Extracorporeal Life Support Organization. ASAIO Journal, 67(3), 221–228. https://doi.org/10.1097/MAT.0000000000001344

Schmitzberger, F. F., Haas, N. L., Coute, R. A., Bartos, J., Hackmann, A., Haft, J. W., Hsu, C. H., Hutin, A., Lamhaut, L., Marinaro, J., Nagao, K., Nakashima, T., Neumar, R., Pellegrino, V., Shinar, Z., Whitmore, S. P., Yannopoulos, D., & Peterson, W. J. (2022). ECPR²: Expert consensus on percutaneous cannulation for extracorporeal cardiopulmonary resuscitation. Resuscitation, 179, 214–220. https://doi.org/10.1016/j.resuscitation.2022.07.003

Suvrein, C. G., van de Glind, E. M. M., de Bruin, S., van den Brink, F. S., van der Hoeven, J. G., & Hoedemaekers, C. W. E. (2023). Early extracorporeal CPR for refractory out-of-hospital cardiac arrest. The New England Journal of Medicine, 388(4), 299–309. https://doi.org/10.1056/NEJMoa2204511

Yannopoulos, D., Bartos, J. A., Raveendran, G., Walser, E., Connett, J., Murray, T. A., Khatri, J., O’Connor, D., Bedi, A., & Aufderheide, T. P. (2020). Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): A phase 2, single centre, open-label, randomised controlled trial. The Lancet, 396(10265), 1807–1816. https://doi.org/10.1016/S0140-6736(20)32338-2