SHI Xiaopeng, YANG Lei, CHENG Yanwei, BAI Weimin, JING Lijuan, QIN Lijie. Prehospital Extracorporeal Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 478-483. DOI: 10.12290/xhyxzz.2022-0675
Citation: SHI Xiaopeng, YANG Lei, CHENG Yanwei, BAI Weimin, JING Lijuan, QIN Lijie. Prehospital Extracorporeal Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 478-483. DOI: 10.12290/xhyxzz.2022-0675

Prehospital Extracorporeal Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest

More Information
  • Corresponding author:

    QIN Lijie, E-mail: qinlijie1819@163.com

  • Received Date: November 26, 2022
  • Accepted Date: February 06, 2023
  • Available Online: February 15, 2023
  • Issue Publish Date: May 29, 2023
  • Achieving return of spontaneous circulation and improving survival during out-of-hospital cardiac arrest (OHCA) is challenging. It has been established that extracorporeal cardiopulmonary resuscitation (ECPR) can be an alternative rescue therapy when conventional cardiopulmonary resuscitation (CCPR) fails to re-establish circulation. Pre-hospital ECPR can reduce the time of inadequate circulation as much as possible. However, the implementation of pre-hospital ECPR needs huge investment, and due to the limitations of site conditions, clinical promotion and application are difficult. Therefore, team cooperation, implementation process and the best beneficiaries of the pre-hospital ECPR still need further study. At present, some medical institutions at home and abroad have carried out the pre-hospital ECPR strategy and achieved some success. Herein, we review the current situation and the prospect of applying prehospital ECPR.
  • [1]
    Deo R, Albert CM. Epidemiology and genetics of sudden cardiac death[J]. Circulation, 2012, 125: 620-637. DOI: 10.1161/CIRCULATIONAHA.111.023838
    [2]
    Virani SS, Alonso A, Aparicio HJ, et al. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association[J]. Circulation, 2021, 143: e254-e743. DOI: 10.1161/CIRCULATIONAHA.120.046677
    [3]
    Extracorporeal Life Support Organization. ECLS Registry Report[EB/OL]. (2022-10-19)[2022-11-27]. https://www.elso.org/registry/internationalsummaryandreports/internationalsummary.aspx.
    [4]
    Yannopoulos D, Bartos JA, Martin C, et al. Minnesota Resuscitation Consortium's Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory Ventricular Fibrillation[J]. J Am Heart Assoc, 2016, 5: e003732. DOI: 10.1161/JAHA.116.003732
    [5]
    Yannopoulos D, Bartos JA, Raveendran G, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial[J]. Lancet, 2020, 396: 1807-1816. DOI: 10.1016/S0140-6736(20)32338-2
    [6]
    Hsu CH, Meurer WJ, Domeier R, et al. Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest (EROCA): Results of a Randomized Feasibility Trial of Expedited Out-of-Hospital Transport[J]. Ann Emerg Med, 2021, 78: 92-101. DOI: 10.1016/j.annemergmed.2020.11.011
    [7]
    D'Arrigo S, Cacciola S, Dennis M, et al. Predictors of favourable outcome after in-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation: A systematic review and meta-analysis[J]. Resuscitation, 2017, 121: 62-70. DOI: 10.1016/j.resuscitation.2017.10.005
    [8]
    Bartos JA, Frascone RJ, Conterato M, et al. The Minnesota mobile extracorporeal cardiopulmonary resuscitation consortium for treatment of out-of-hospital refractory ventricular fibrillation: Program description, performance, and outcomes[J]. EClinical Medicine, 2020, 29-30: 100632. DOI: 10.1016/j.eclinm.2020.100632
    [9]
    Hutin A, Ricard-Hibon A, Briole N, et al. First Description of a Helicopter-Borne ECPR Team for Remote Refractory Out-of-Hospital Cardiac Arrest[J]. Prehosp Emerg Care, 2021. doi: 10.1080/10903127.2020.1859026.
    [10]
    Abrams D, Combes A, Brodie D. Extracorporeal membrane oxygenation in cardiopulmonary disease in adults[J]. J Am Coll Cardiol, 2014, 63: 2769-2778. DOI: 10.1016/j.jacc.2014.03.046
    [11]
    Bělohlávek J, Mlček M, Huptych M, et al. Coronary versus carotid blood flow and coronary perfusion pressure in a pig model of prolonged cardiac arrest treated by different modes of venoarterial ECMO and intraaortic balloon counterpulsation[J]. Crit Care, 2012, 16: R50. DOI: 10.1186/cc11254
    [12]
    Yu HY, Wang CH, Chi NH, et al. Effect of interplay between age and low-flow duration on neurologic outcomes of extracorporeal cardiopulmonary resuscitation[J]. Intensive Care Med, 2019, 45: 44-54. DOI: 10.1007/s00134-018-5496-y
    [13]
    Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J]. Circulation, 2015, 132: S444-S464. http://smartsearch.nstl.gov.cn/paper_detail.html?id=3c8a94d517ceae67112e7e6804f2d3a8
    [14]
    Brooks SC, Anderson ML, Bruder E, et al. Part 6: Alternative Techniques and Ancillary Devices for Cardiopul-monary Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J]. Circulation, 2015, 132: S436-S443. http://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsRW5nTmV3UzIwMjEwMzAyEiAyN2U1MTQwNDI5YzA5NmRlZTRiMTgzZGZhOTA2OWU0MBoIeTRyaTE0OGw%3D
    [15]
    Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J]. Circulation, 2020, 142: S366-S468. http://pubmed.ncbi.nlm.nih.gov/33081529/
    [16]
    Soar J, Böttiger BW, Carli P, et al. European Resuscitation Council Guidelines 2021: Adult advanced life support[J]. Resuscitation, 2021, 161: 115-151. DOI: 10.1016/j.resuscitation.2021.02.010
    [17]
    Lamhaut L, Hutin A, Puymirat E, et al. A Pre-Hospital Extracorporeal Cardio Pulmonary Resuscitation (ECPR) strategy for treatment of refractory out hospital cardiac arrest: An observational study and propensity analysis[J]. Resuscitation, 2017, 117: 109-117. DOI: 10.1016/j.resuscitation.2017.04.014
    [18]
    Marinaro J, Guliani S, Dettmer T, et al. Out-of-hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: a case report[J]. J Am Coll Emerg Physicians Open, 2020, 1: 153-157. DOI: 10.1002/emp2.12033
    [19]
    中国老年医学学会急诊医学分会, 中国老年医学学会急诊医学分会ECMO工作委员会. 成人体外膜肺氧合辅助心肺复苏(ECPR)实践路径[J]. 中华急诊医学杂志, 2019, 28: 1197-1203. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS202009008.htm
    [20]
    Alwardt CM, Wilson DS, Alore ML, Lanza LA, Devaleria PA, Pajaro OE. Performance and Safety of an Integrated Portable Extracorporeal Life Support System for Adults[J]. J Extra Corpor Technol, 2015, 47: 38-43. http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=PMC4566819&blobtype=pdf
    [21]
    于洁, 乔叶薷, 马金辉, 等. 基于德尔菲法构建体外膜肺氧合辅助心肺复苏临床治疗专家共识[J]. 中国体外循环杂志, 2016, 14: 193-196. https://www.cnki.com.cn/Article/CJFDTOTAL-TWXH201604002.htm
    [22]
    中华医学会急诊医学分会复苏学组, 成人体外心肺复苏专家共识组. 成人体外心肺复苏专家共识[J]. 中华急诊医学杂志, 2018, 27: 22-29.
    [23]
    Laussen PC, Guerguerian Anne-Marie. Establishing and Sustaining an ECPR Program[J]. Front Pediatr, 2018, 6: 152. DOI: 10.3389/fped.2018.00152
    [24]
    Debaty G, Babaz V, Durand M, et al. Prognostic factors for extracorporeal cardiopulmonary resuscitation recipients following out-of-hospital refractory cardiac arrest[J]. Resuscitation, 2017, 112: 1-10. DOI: 10.1016/j.resuscitation.2016.12.011
    [25]
    Mosier JM, Kelsey M, Raz Y, et al. Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions[J]. Crit Care, 2015, 19: 431. DOI: 10.1186/s13054-015-1155-7
    [26]
    Bartos JA, Yannopoulos D. Refractory cardiac arrest: where extracorporeal cardiopulmonary resuscitation fits[J]. Curr Opin Crit Care, 2020, 26: 596-602. DOI: 10.1097/MCC.0000000000000769
    [27]
    Bartos JA, Grunau B, Carlson C, et al. Improved Survival With Extracorporeal Cardiopulmonary Resuscita-tion Despite Progres-sive Metabolic Derangement Associated With Prolonged Resuscitation[J]. Circulation, 2020, 141: 877-886. DOI: 10.1161/CIRCULATIONAHA.119.042173
    [28]
    Reynolds JC, Grunau BE, Elmer J, et al. Prevalence, natural history, and time-dependent outcomes of a multi-center North American cohort of out-of-hospital cardiac arrest extracorporeal CPR candidates[J]. Resuscitation, 2017, 117: 24-31. DOI: 10.1016/j.resuscitation.2017.05.024
    [29]
    Han SJ, Kim HS, Choi HH, et al. Predictors of survival following extracorporeal cardiopulmonary resuscitation in patients with acute myocardial infarction-complicated refractory cardiac arrest in the emergency department: a retrospective study[J]. J Cardiothorac Surg, 2015, 10: 23. DOI: 10.1186/s13019-015-0212-2
    [30]
    Chonde M, Escajeda J, Elmer J, et al. Challenges in the development and implementation of a healthcare system based extracorporeal cardiopulmonary resuscitation (ECPR) program for the treatment of out of hospital cardiac arrest[J]. Resuscitation, 2020, 148: 259-265. DOI: 10.1016/j.resuscitation.2019.12.015
    [31]
    Douflé G, Roscoe A, Billia F, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation published correction appears in Crit Care[J]. Crit Care, 2015, 19: 326. DOI: 10.1186/s13054-015-1042-2
    [32]
    MacLaren G, Masoumi A, Brodie D. ECPR for out-of-hospital cardiac arrest: more evidence is needed[J]. Crit Care, 2020, 24: 7. DOI: 10.1186/s13054-019-2722-0
    [33]
    Girotra S, Nallamothu BK, Spertus JA, et al. Trends in survival after in-hospital cardiac arrest[J]. N Engl J Med, 2012, 367: 1912-1920. DOI: 10.1056/nejmoa1109148
  • Related Articles

    [1]LI Zhimao, WANG Dandi, ZHANG Ting, MEI Qimin, LIU Yecheng, ZHU Huadong. Comparative Efficacy of Amiodarone and Lidocaine in Patients with Cardiac Arrest: A Systematic Review and Meta-analysis[J]. Medical Journal of Peking Union Medical College Hospital, 2025, 16(2): 406-415. DOI: 10.12290/xhyxzz.2024-0840
    [2]ZHANG Nan, LIN Qingting, ZHU Huadong. Prediction Model for In-hospital Death of Patients with Cardiac Arrest[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1023-1030. DOI: 10.12290/xhyxzz.2023-0378
    [3]ZHAO Tingting, ZHAO Yuanyuan, XING Jihong. Analysis of Clinical Characteristics and Resuscitation Outcomes of Adult Patients with In-hospital Cardiac Arrest[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 536-542. DOI: 10.12290/xhyxzz.2022-0623
    [4]GONG Huanhuan, KE Xiaowei, WANG Aimin, LI Xiangmin. An Interpretable Machine Learning Model for Predicting In-hospital Death Risk in Patients with Cardiac Arrest: Based on US Medical Information Mart for Intensive Care Database Ⅳ 2.0[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 528-535. DOI: 10.12290/xhyxzz.2022-0733
    [5]LI Feng, WU Xinjie, CHEN Qijiang, LIU Ying, XU Jiefeng, ZHOU Guangju, ZHANG Mao. Effects of Artesunate on Lung Injury After Cardiac Arrest and Resuscitation in Pigs and Its Mechanism[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 520-527. DOI: 10.12290/xhyxzz.2022-0730
    [6]PENG Xiang, LI Xiangmin. Application of Near Infrared Spectroscopy in Cardiopulmonary Resuscitation[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 459-464. DOI: 10.12290/xhyxzz.2022-0637
    [7]ZHANG Mao, XU Shanxiang. Resuscitation Center: An Effective Way for Hospitals to Gain High-quality Development[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 449-452. DOI: 10.12290/xhyxzz.2023-0102
    [8]ZHANG Hongmin, CHEN Xiukai, WANG Xiaoting, LIU Dawei, CHAI Wenzhao. Peak Value of Central Venous Pressure and Acute Kidney Injury in Cardiac Patients After Cardiopulmonary Bypass Surgery[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 1005-1011. DOI: 10.12290/xhyxzz.2022-0448
    [9]Implantable Cardiac Devices Technology(2013)[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(1): 41-41.
  • Cited by

    Periodical cited type(4)

    1. 谢丽丽,于浪琴,涂惠. 成人院外心搏骤停预后相关因素的研究进展. 全科护理. 2025(02): 240-244 .
    2. 李岸青,马凌燕,于漫,牛子妹. 1例院外心脏骤停患者体外心肺复苏救治的护理. 天津护理. 2024(05): 603-606 .
    3. 刘宝齐,刘纪敏. 插入式腹部提压心肺复苏在心搏骤停患者中的应用效果分析. 实用中西医结合临床. 2024(17): 12-14+21 .
    4. 周浩,丁涛,时育彤,张忠满,朱轶,陈旭锋,李伟. 体外心肺复苏患者在ECMO支持期间发生院内获得性感染的危险因素分析. 中国急救医学. 2024(11): 938-942 .

    Other cited types(0)

Catalog

    Article Metrics

    Article views (1901) PDF downloads (194) Cited by(4)
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close