학술논문
Implementing enhanced extracorporeal membrane oxygenation for CPR (ECPR) in the emergency department.
Document Type
Academic Journal
Author
Oliver M; Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, Australia. Drmatoliver@gmail.com.; University of Sydney Medical School, Sydney, Australia. Drmatoliver@gmail.com.; Greenlight Institute for Emergency Care, Royal Prince Alfred Hospital, Sydney, Australia. Drmatoliver@gmail.com.; Coggins A; University of Sydney Medical School, Sydney, Australia.; Department of Emergency Medicine, Westmead Hospital, Sydney, Australia.; Kruit N; University of Sydney Medical School, Sydney, Australia.; Department of Anaesthesia, Westmead Hospital, Sydney, Australia.; Aeromedical Retrieval Services, New South Wales Ambulance, Sydney, Australia.; Department of Anaesthesia, Royal Prince Alfred Hospital, Sydney, Australia.; Burns B; University of Sydney Medical School, Sydney, Australia.; Aeromedical Retrieval Services, New South Wales Ambulance, Sydney, Australia.; Plunkett B; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia.; Morgan S; Department of Intensive Care Services, St Vincent's Hospital, Sydney, Australia.; Southwood TJ; Department of Intensive Care Services, Royal Prince Alfred Hospital, Sydney, Australia.; Totaro R; Department of Intensive Care Services, Royal Prince Alfred Hospital, Sydney, Australia.; Forrest P; Department of Anaesthesia, Royal Prince Alfred Hospital, Sydney, Australia.; Russell SB; Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, Australia.; Greenlight Institute for Emergency Care, Royal Prince Alfred Hospital, Sydney, Australia.; Carey R; Department of Intensive Care Services, Royal Prince Alfred Hospital, Sydney, Australia.; Dennis M; University of Sydney Medical School, Sydney, Australia.; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 101469435 Publication Model: Electronic Cited Medium: Print ISSN: 1865-1372 (Print) Linking ISSN: 18651372 NLM ISO Abbreviation: Int J Emerg Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1865-1372
Abstract
Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge. The best outcomes for ECPR occur when the time from cardiac arrest to implementation of ECPR is minimised. To reduce this time, systems must be in place to identify the correct patient, expedite transfer to hospital, facilitate rapid cannulation and ECMO circuit flows. We describe the process of activation of ECPR, patient selection, and the steps that emergency department clinicians can utilise to facilitate timely cannulation to ensure the best outcomes for patients in refractory cardiac arrest. With these processes in place our survival to hospital discharge for OHCA patients is 35%, with most patients having a good neurological function.
(© 2024. Crown.)
(© 2024. Crown.)