ECMO in Cardiac Arrest: A Narrative Review of the Literature
Abstract
:1. Introduction
2. Methods
3. Place of Implementation of the ECPR
4. Equipment and Technique for Setting Up ECPR
5. Patient Selection Process
6. Patients Management after ECPR
7. Neurological Outcomes
8. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Percutaneous ECMO insertion kit |
Vascular ultrasound probe with sterile protection |
Echocardiography with Doppler mode |
ECMO pump compatible with transportation |
Backup ECMO pump |
A battery that can last 45 min minimum |
Clamps for cannulas/circuit |
Surgery instruments for any hemorrhagic complications |
Additional light for surgery |
Heater for ECMO |
Equipment for in-hospital transportation |
ECMO pump transportation Cart |
Emergency bag with all drugs and clamps |
ECMO already primed available 24 h/24 |
Vascular Doppler or NIRS to check distal perfusion of the leg |
Fiberoptic bronchoscope |
Any device able to unload the left ventricle (IABP, Impella®) |
Favorable Criteria |
---|
Refractory CA with reversible cause |
Witnessed CA |
High quality CPR started immediately |
Age < 70 |
Initial shockable rhythm |
EtCO2 > 10 mmHg |
Signs of life under CPR |
Reaching hospital < 40 min allowing ECMO initiation < 60 min. (Maximum low-flow < 60 min) |
Pulse perceived under CPR |
Unfavorable Criteria |
CA without any witnesses and/or ignorance of the duration of the no-flow |
No-flow > 3 min and/or Low-flow > 90 min |
Poor quality CPR (EtCO2 < 10 mmHg and/or absence of pulse perceived under massage) |
Non-shockable initial rhythm |
Major comorbidities |
Obvious clinical signs of irreversible death (rigidity, lividity) |
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De Charrière, A.; Assouline, B.; Scheen, M.; Mentha, N.; Banfi, C.; Bendjelid, K.; Giraud, R. ECMO in Cardiac Arrest: A Narrative Review of the Literature. J. Clin. Med. 2021, 10, 534. https://doi.org/10.3390/jcm10030534
De Charrière A, Assouline B, Scheen M, Mentha N, Banfi C, Bendjelid K, Giraud R. ECMO in Cardiac Arrest: A Narrative Review of the Literature. Journal of Clinical Medicine. 2021; 10(3):534. https://doi.org/10.3390/jcm10030534
Chicago/Turabian StyleDe Charrière, Amandine, Benjamin Assouline, Marc Scheen, Nathalie Mentha, Carlo Banfi, Karim Bendjelid, and Raphaël Giraud. 2021. "ECMO in Cardiac Arrest: A Narrative Review of the Literature" Journal of Clinical Medicine 10, no. 3: 534. https://doi.org/10.3390/jcm10030534