The effect of a structured ECPR protocol aided by specific simulation training in a quaternary ECMO centre: A retrospective pre-post study

Read, Andrew C.; Morgan, Stephen; Reynolds, Claire; Breeding, Jeff; Scott, Sean; Lowe, David; Newman, Sally; Kennedy, Rosemary; Buscher, Hergen

doi:10.1016/j.resplu.2022.100234

Cited by 9 publications

(7 citation statements)

References 23 publications

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“…A major point of criticism that was raised concerning the external validity of the INCEPTION trial is the time from cardiac arrest to ECMO flow which was 74 min median, which is substantially longer than in the ARREST trial and the Prague OHCA study (mean 59 min and median 61 min, respectively). However, the low flow times achieved during the INCEPTION trial are comparable to those typically achieved by other large centers presenting their experience with ECPR [12,13 ▪ ,14,15 ▪ ,16–18], underlining the real-world representativity and external validity of the results of the INCEPTION trial.…”

Section: Efficacy and Effectivenessmentioning

confidence: 53%

Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest – current status

Suverein,

Maessen,

van de Poll

2023

Current Opinion in Critical Care

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Purpose of review Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging treatment for refractory cardiac arrest. In recent years, several randomized controlled trials have been published that aimed to address the efficacy and effectiveness of ECPR for out-of-hospital cardiac arrest (OHCA). Despite the lack of high-quality evidence concerning clinical effectiveness and cost-effectiveness, ECPR is increasingly implemented throughout the world. In this review, we aim to provide an overview of the current status of ECPR for OHCA. Recent findings Randomized controlled trials showed diverging results, largely due to differences in selection criteria and study design. Single-center studies, performed in centers with extraordinary expertise and dedication consistently achieve a low-flow time of around 60 min, but such achievements are rarely reproduced outside these centers. Strict patient selection can improve outcome but simultaneously limits the caseload. Preliminary data suggest that outcome may also be improved by avoiding hyperoxia postresuscitation. Summary The potential of ECPR to increase survival in selected patients in highly dedicated systems seems to be proven, the question remains whether ECPR for OHCA can be widely implemented successfully and can develop into a sustainable, commonplace resource-effective treatment.

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Section: Efficacy and Effectivenessmentioning

confidence: 53%

Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest – current status

Suverein,

Maessen,

van de Poll

2023

Current Opinion in Critical Care

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“…As part of this, there needs to be a series of people to perform chest compressions, or a mechanical compressor device, along with individuals who can secure or manage the airway, those who can administer ACLS medications, and those who can “run” the resuscitation (63, 64). Due to the complexity of the cannulation process, simulation may play an important role for centers in maintaining competency and practice (65).…”

Section: Cannulationmentioning

confidence: 99%

Extracorporeal Cardiopulmonary Resuscitation

Tonna,

Cho

2024

Critical Care Medicine

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“…Generally, studies enrolling adult IHCA and OHCA patients reported improved and favorable neurological outcomes associated with ECPR. 38,40 A study by Bartos et al demonstrated that for CPR durations of less than 60 minutes, ECPR was associated with favorable neurological outcomes and survival despite significantly higher metabolic derangement as compared with CCPR. 32 Our observations are consistent with findings of another meta-analysis which compared ECPR and CCPR for patients with CA and found that ECPR was related to statistically significant improvement, 30-day survival, and neurologic outcomes for patients with IHCA (RR = 1.60, 95% CI = 1.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…38 Additionally, ECPR effectively reduced the time from OHCA to ECMO under an ECPR-specific program implementation. 40 (Table 3 provided as in Supplemental Material shows the study design, objectives, interventions, outcomes, and results with neurological outcomes. )…”

Section: Quality Assessmentmentioning

confidence: 99%

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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The effect of a structured ECPR protocol aided by specific simulation training in a quaternary ECMO centre: A retrospective pre-post study

Cited by 9 publications

References 23 publications

Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest – current status

Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest – current status

Extracorporeal Cardiopulmonary Resuscitation

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

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