Pre-hospital extra-corporeal cardiopulmonary resuscitation

• Main Authors: Ben Singer, Joshua C. Reynolds, David J. Lockey, Ben O’Brien
• Format: Article
• Language: English
• Published: BMC 2018-03-01
• Series: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
• Subjects: Pre-hospital; Extracorporeal cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Extracorporeal life support
• Online Access: http://link.springer.com/article/10.1186/s13049-018-0489-y

Abstract Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest compressions. Hospital-based ECPR is currently offered to selected OHCA patients in specialized centres. The interval between collapse and restoration of circulation is inversely associated with good clinical outcomes after ECPR. Pre-hospital delivery of ECPR concurrent with conventional resuscitation is one approach to shortening this interval and improving outcomes after OHCA. This article examines the background and rationale for pre-hospital ECPR; summarises the findings of a literature search for published evidence; and considers candidate selection, logistics, and complications for this complex intervention.