Benefits, key protocol components, and considerations for successful implementation of extracorporeal cardiopulmonary resuscitation: a review of the recent literature

Jeung, Kyung Woon; Jung, Yong Hun; Gumucio, Jorge Antonio; Salcido, David D.; Menegazzi, James J.

doi:10.15441/ceem.23.063

Cited by 4 publications

(1 citation statement)

References 134 publications

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“…In selected patients, mechanical circulatory support can restore hemodynamic stability and end-organ perfusion; it acts as a bridge to definitive therapy in patients with refractory shock to maximal medical treatment. This can be achieved using an intra-aortic balloon pump, Impella, left ventricular assist device, and venoarterial extracorporeal membrane oxygenator[ 91 - 93 ].…”

Section: Multi-disciplinary Approach For Pamd and Circulatory Failurementioning

confidence: 99%

Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit

El-Menyar,

Wahlen

2024

World J Cardiol

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The post-resuscitation period is recognized as the main predictor of cardiopulmonary resuscitation (CPR) outcomes. The first description of post-resuscitation syndrome and stony heart was published over 50 years ago. Major manifestations may include but are not limited to, persistent precipitating pathology, systemic ischemia/reperfusion response, post-cardiac arrest brain injury, and finally, post-cardiac arrest myocardial dysfunction (PAMD) after successful resuscitation. Why do some patients initially survive successful resuscitation, and others do not? Also, why does the myocardium response vary after resuscitation? These questions have kept scientists busy for several decades since the first successful resuscitation was described. By modifying the conventional modalities of resuscitation together with new promising agents, rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal, stony heart. Community awareness and staff education are crucial for shortening the resuscitation time and improving short- and long-term outcomes. Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes. This review extensively addresses the underlying pathophysiology, management, and outcomes of post-resuscitation syndrome. The pattern, management, and outcome of PAMD and post-cardiac arrest shock are different based on many factors, including in-hospital cardiac arrest vs out-of-hospital cardiac arrest (OHCA), witnessed vs unwitnessed cardiac arrest, the underlying cause of arrest, the duration, and protocol used for CPR. Although restoring spontaneous circulation is a vital sign, it should not be the end of the game or lone primary outcome; it calls for better understanding and aggressive multi-disciplinary interventions and care. The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.

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Section: Multi-disciplinary Approach For Pamd and Circulatory Failurementioning

confidence: 99%

Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit

El-Menyar,

Wahlen

2024

World J Cardiol

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Variability in patient selection criteria across extracorporeal cardiopulmonary resuscitation (ECPR) systems: A systematic review

Alenazi,

Aljanoubi,

Yeung

et al. 2024

Resuscitation

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Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems

Winnersbach,

Wallraff,

Schadow

et al. 2024

ASAIO Journal

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According to the Extracorporeal Life Support Organization (ELSO) guidelines, pre-assembled and already primed extracorporeal membrane oxygenation (ECMO) systems can be safely stored for up to 30 days under specific conditions. This study gives a detailed overview of existing pre-assembly practices. An anonymous online survey was conducted among chief perfusionists at German ECMO centers. Forty-four of a total of 83 ECMO centers (53%) completed the survey. Thirty-three percent do not preassemble ECMO systems. Seventy-seven percent (n = 34) reported having preassembled ECMO systems readily available (30% dry preassembly/20% wet preassembly/27% wet preassembly with circulation). Half of the participating centers (50%) reported having a standard operating procedure (SOP) and the majority (57%) of chief perfusionists expressed a need for an evidence-based SOP. A maximum storage time for wet preassembled ECMO systems is established in 88% of departments. On average, wet preassembled systems are discarded after 20 days, which is below the ELSO’s safe limit of 30 days. Overall, this survey reveals a heterogeneous approach regarding the practice of provisioning preassembled ECMO systems. The demand for an evidence-based SOP for the preassembly and storing of ECMO systems becomes evident, necessitating the determination of hygienic standards, regular training, and a reliable maximum storage period.

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Benefits, key protocol components, and considerations for successful implementation of extracorporeal cardiopulmonary resuscitation: a review of the recent literature

Cited by 4 publications

References 134 publications

Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit

Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit

Variability in patient selection criteria across extracorporeal cardiopulmonary resuscitation (ECPR) systems: A systematic review

Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems

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