Thursday, June 12, 2014

Extracorporeal cardiopulmonary resuscitation.(ECPR)

Curr Opin Crit Care. 2014 Jun;20(3):259-65

This review highlights that ECPR is feasible for both In Hospital Cardiac Arrest  and Out of Hospital Cardiac Arrest . In the recent series, the outcome of ECPR in In Hospital Cardiac Arrest  is satisfactory, with survival rates good with neurologic outcome reaching the 40-50% range. All series converge in highlighting that time from cardiac arrest to ECMO flow is a critical determinant of outcome, with survival rates of 50% when initiated within 30min of In Hospital Cardiac Arrest, 30% between 30 and 60min, and 18% after 60min. Results of ECPR in Out  of Hospital Cardiac Arrest  are more challenging. Recent series suggest that good outcome can be obtained in 15-20% of the patients, provided that time from arrest to ECMO is shorter than 60min. Duration of cardiac arrest seems to be more important than location of cardiac arrest. ECPR thus seems to be a valuable option in selected cases

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