In-hospital extracorporeal cardiopulmonary resuscitation for patients with an out-of-hospital cardiac arrest in a semi-rural setting: An observational study on the implementation of a helicopter emergency medical services pathway

Avest, Ewoud ter; Tunnicliff, M.; Griggs, J. E.; Griffiths, D.; Cody, D.; Nelson, Malcolm; Hurst, T.; Lyon, Richard

doi:10.1016/j.resplu.2022.100339

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…47 While our literature review evaluated the criteria under which ECPR should be performed, four studies reported the need to evaluate CA patients for eligibility to see if they fit for ECPR therapy. 35,39,41,42 These studies report higher survival associated with carefully selected patients after meeting inclusion criteria. 39 These results are significant as they demonstrate the need to make early patient selection conceivable and necessary prior to ECPR therapy.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…In that regard, Te Avest et al suggest that one of the factors to consider is the effectiveness of in-hospital ECPR, which appears to be of little importance in rural setups, as potentially ECPReligible patients would deteriorate prior to their arrival to the hospital. 42 This is imperative since as ECPR awareness grows and pre-hospital mechanical CPR is introduced, it is plausible that not only more ECPR eligible cases will present to the emergency department (ED), but may also predict a rise in ECPR ineligible patients. 48 Time to return of spontaneous circulation, ROSC, CPR duration, and extracorporeal membrane oxygenation were evaluated as an effect of ECPR in this literature review and were reported in most of included articles.…”

Section: Quality Assessmentmentioning

confidence: 99%

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Extracorporeal cardiopulmonary resuscitation as a standard of care in the future: a literature review

Patel,

Saab

et al. 2023

F1000Res

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Background: The use of extracorporeal cardiopulmonary resuscitation (ECPR) is limited generally to situations where traditional CPR failed to restore a patient's heart rhythm. Although ECPR is not regarded as the standard of care for cardiac arrest patients, it might be a more effective treatment for some forms of cardiac arrest. This literature review explores the efficacy of ECPR as a potential standard of care for cardiac arrest in the future. Methods: English language publications fulfilling eligibility criteria from 2010 to 2023 were found through a literature search using four electronic databases (PubMed, Google Scholar, Cochrane, and IEEE Explore). Articles were included in this literature review for fulfilling following criteria: empirical primary studies evaluating ECPR in human subjects with either IHCA or OHCA; articles published in English between 2010 and 2023; articles exploring ECPR in cardiac arrest across all ages of patients. Results: 12 studies out of 1,092 search results met the inclusion criteria for data extraction and synthesis. Data extracted included the efficacy of ECPR in both IHCA and OHCA patients based on the PICO framework. The quality of study done by NOS (Newcastle-Ottawa Quality Assessment Scale for Cohort Studies) resulted in three studies with moderate quality while nine were of high quality. Conclusions: ECPR was associated with neurologically intact survival with favorable neurological outcomes compared to a standard CRP for cardiac arrest patients. This study also demonstrates that, at the moment, ECPR is the most successful in centers with a well-trained multidisciplinary ECMO team of experts. On the other hand, cardiac arrest patients in semi-rural areas and underdeveloped locations are likely to benefit less from ECPR interventions due to the lack of necessary ECPR expertise and infrastructure. Those individuals eligible for ECPR benefit from better neurological outcomes and associated higher survival rates.

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