CONTEXT: Extracorporeal cardiopulmonary resuscitation (ECPR) refers to emergent percutaneous veno-arterial cardiopulmonary bypass to stabilize and provide temporary support of patients who suffer cardiopulmonary arrest. Initiation of ECPR by emergency physicians with meaningful long-term patient survival has not been demonstrated. OBJECTIVE: To determine whether emergency physicians could successfully incorporate ECPR into the resuscitation of patients who present to the emergency department (ED) with cardiopulmonary collapse refractory to traditional resuscitative efforts. DESIGN: A three-stage algorithm was developed for ED ECPR in patients meeting inclusion/exclusion criteria. We report a case series describing our experience with this algorithm over a 1-year period. RESULTS: 42 patients presented to our ED with cardiopulmonary collapse over the 1-year study period. Of these, 18 patients met inclusion/exclusion criteria for the algorithm. 8 patients were admitted to the hospital after successful ED ECPR and 5 of those patients survived to hospital discharge neurologically intact. 10 patients were not started on bypass support because either their clinical conditions improved or resuscitative efforts were terminated. CONCLUSION: Emergency physicians can successfully incorporate ED ECPR in the resuscitation of patients who suffer acute cardiopulmonary collapse. More studies are necessary to determine the true efficacy of this therapy.
CONTEXT: Extracorporeal cardiopulmonary resuscitation (ECPR) refers to emergent percutaneous veno-arterial cardiopulmonary bypass to stabilize and provide temporary support of patients who suffer cardiopulmonary arrest. Initiation of ECPR by emergency physicians with meaningful long-term patient survival has not been demonstrated. OBJECTIVE: To determine whether emergency physicians could successfully incorporate ECPR into the resuscitation of patients who present to the emergency department (ED) with cardiopulmonary collapse refractory to traditional resuscitative efforts. DESIGN: A three-stage algorithm was developed for ED ECPR in patients meeting inclusion/exclusion criteria. We report a case series describing our experience with this algorithm over a 1-year period. RESULTS: 42 patients presented to our ED with cardiopulmonary collapse over the 1-year study period. Of these, 18 patients met inclusion/exclusion criteria for the algorithm. 8 patients were admitted to the hospital after successful ED ECPR and 5 of those patients survived to hospital discharge neurologically intact. 10 patients were not started on bypass support because either their clinical conditions improved or resuscitative efforts were terminated. CONCLUSION: Emergency physicians can successfully incorporate ED ECPR in the resuscitation of patients who suffer acute cardiopulmonary collapse. More studies are necessary to determine the true efficacy of this therapy.
Authors: Joseph E Tonna; Nicholas J Johnson; John Greenwood; David F Gaieski; Zachary Shinar; Joseph M Bellezo; Lance Becker; Atman P Shah; Scott T Youngquist; Michael P Mallin; James Franklin Fair; Kyle J Gunnerson; Cindy Weng; Stephen McKellar Journal: Resuscitation Date: 2016-08-11 Impact factor: 5.262
Authors: Alexander Sacha C Richardson; Joseph E Tonna; Vinodh Nanjayya; Paul Nixon; Darryl C Abrams; Lakshmi Raman; Stephen Bernard; Simon J Finney; Brian Grunau; Scott T Youngquist; Stephen H McKellar; Zachary Shinar; Jason A Bartos; Lance B Becker; Demetris Yannopoulos; Jan Bˇelohlávek; Lionel Lamhaut; Vincent Pellegrino Journal: ASAIO J Date: 2021-03-01 Impact factor: 3.826
Authors: Joseph K Maddry; R Madelaine Paredes; Joni A Paciocco; Maria Castaneda; Allyson A Araña; Crystal A Perez; Lauren K Reeves; Ryan K Newberry; Vikhyat S Bebarta; Nurani Kester; Phillip E Mason Journal: AEM Educ Train Date: 2020-04-16