Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center
Extracorporeal Cardiopulmonary Resuscitation (ECPR) is an emerging approach to cardiac arrest. We present two contrasting cases from a high-volume extracorporeal membrane oxygenation (ECMO) center (defined as greater than 30 ECMO cases per year) without a 24/7 ECPR program to highlight how to establ...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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EDP Sciences
2023-12-01
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| Series: | The Journal of ExtraCorporeal Technology |
| Subjects: | |
| Online Access: | https://ject.edpsciences.org/articles/ject/full_html/2023/04/ject230038/ject230038.html |
| _version_ | 1827160684090097664 |
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| author | Michalakes Peter C DeNino Walter F Jara Claire B Afari Maxwell E Geller Bram J |
| author_facet | Michalakes Peter C DeNino Walter F Jara Claire B Afari Maxwell E Geller Bram J |
| author_sort | Michalakes Peter C |
| collection | DOAJ |
| description | Extracorporeal Cardiopulmonary Resuscitation (ECPR) is an emerging approach to cardiac arrest. We present two contrasting cases from a high-volume extracorporeal membrane oxygenation (ECMO) center (defined as greater than 30 ECMO cases per year) without a 24/7 ECPR program to highlight how to establish an ECPR program with a focus on patient selection and outcome optimization. In one case, a patient presented with cardiac arrest during initial triage for chest pain within the emergency department, and in the other case, a patient experienced an out-of-hospital cardiac arrest with prolonged no-flow and low-flow time. Despite the lack of a 24/7 ECPR program at the presenting center, both patients received an ECPR evaluation, as both patients presented while all services necessary for ECMO cannulation were available. The in-hospital cardiac arrest patient was successfully cannulated for ECMO during cardiopulmonary resuscitation and survived with few complications. The out-of-hospital cardiac arrest patient was deemed a poor candidate for ECPR and expired soon after presentation. These two cases highlight the complex decision-making in ECPR and further illustrate how to create ECPR protocols at a high-volume ECMO center before resources are available for a 24/7 ECPR program. |
| first_indexed | 2024-03-07T21:37:28Z |
| format | Article |
| id | doaj.art-51de5ea3c51f4dfd80260105a31c672b |
| institution | Directory Open Access Journal |
| issn | 0022-1058 2969-8960 |
| language | English |
| last_indexed | 2025-03-21T00:16:56Z |
| publishDate | 2023-12-01 |
| publisher | EDP Sciences |
| record_format | Article |
| series | The Journal of ExtraCorporeal Technology |
| spelling | doaj.art-51de5ea3c51f4dfd80260105a31c672b2024-08-03T09:07:34ZengEDP SciencesThe Journal of ExtraCorporeal Technology0022-10582969-89602023-12-0155418518810.1051/ject/2023042ject230038Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation CenterMichalakes Peter C0https://orcid.org/0000-0002-0511-6091DeNino Walter F1Jara Claire B2Afari Maxwell E3Geller Bram J4https://orcid.org/0000-0002-0767-5102Tufts University School of MedicineTufts University School of MedicineDepartment of Cardiovascular Perfusion, Maine Medical CenterTufts University School of MedicineTufts University School of MedicineExtracorporeal Cardiopulmonary Resuscitation (ECPR) is an emerging approach to cardiac arrest. We present two contrasting cases from a high-volume extracorporeal membrane oxygenation (ECMO) center (defined as greater than 30 ECMO cases per year) without a 24/7 ECPR program to highlight how to establish an ECPR program with a focus on patient selection and outcome optimization. In one case, a patient presented with cardiac arrest during initial triage for chest pain within the emergency department, and in the other case, a patient experienced an out-of-hospital cardiac arrest with prolonged no-flow and low-flow time. Despite the lack of a 24/7 ECPR program at the presenting center, both patients received an ECPR evaluation, as both patients presented while all services necessary for ECMO cannulation were available. The in-hospital cardiac arrest patient was successfully cannulated for ECMO during cardiopulmonary resuscitation and survived with few complications. The out-of-hospital cardiac arrest patient was deemed a poor candidate for ECPR and expired soon after presentation. These two cases highlight the complex decision-making in ECPR and further illustrate how to create ECPR protocols at a high-volume ECMO center before resources are available for a 24/7 ECPR program.https://ject.edpsciences.org/articles/ject/full_html/2023/04/ject230038/ject230038.htmlextracorporeal cardiopulmonary resuscitation (ecpr)extracorporeal membrane oxygenation (ecmo)cardiac arrest |
| spellingShingle | Michalakes Peter C DeNino Walter F Jara Claire B Afari Maxwell E Geller Bram J Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center The Journal of ExtraCorporeal Technology extracorporeal cardiopulmonary resuscitation (ecpr) extracorporeal membrane oxygenation (ecmo) cardiac arrest |
| title | Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center |
| title_full | Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center |
| title_fullStr | Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center |
| title_full_unstemmed | Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center |
| title_short | Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center |
| title_sort | building an extracorporeal cardiopulmonary resuscitation program at a high volume extracorporeal membrane oxygenation center |
| topic | extracorporeal cardiopulmonary resuscitation (ecpr) extracorporeal membrane oxygenation (ecmo) cardiac arrest |
| url | https://ject.edpsciences.org/articles/ject/full_html/2023/04/ject230038/ject230038.html |
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