Year : 2017  |  Volume : 20  |  Issue : 5  |  Page : 4--10

Extracorporeal membrane oxygenation for refractory cardiac arrest

Steven A Conrad1, Peter T Rycus2 
1 Division of Critical Care Medicine, Louisiana State University Health Sciences Center; University Health Shreveport, Extracorporeal Life Support Program, Shreveport, Louisiana, USA
2 Extracorporeal Life Support Organization, Ann Arbor, Michigan, USA

Correspondence Address:
Steven A Conrad
Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, Louisiana

Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates. Percutaneous cannulation where feasible is rapid and can be performed by nonsurgeons (emergency physicians, intensivists, cardiologists, and interventional radiologists). Modern extracorporeal systems are easy to prime and manage and are technically easy to manage with proper training and experience. ECPR can be deployed in the emergency department for out-of-hospital arrest or in various inpatient units for in-hospital arrest. ECPR should be considered for patients with refractory cardiac arrest in hospitals with an existing extracorporeal life support program, able to provide rapid deployment of support, and with resources to provide postresuscitation evaluation and management.

How to cite this article:
Conrad SA, Rycus PT. Extracorporeal membrane oxygenation for refractory cardiac arrest.Ann Card Anaesth 2017;20:4-10

How to cite this URL:
Conrad SA, Rycus PT. Extracorporeal membrane oxygenation for refractory cardiac arrest. Ann Card Anaesth [serial online] 2017 [cited 2020 Sep 27 ];20:4-10
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