Klee Tyler E, Kern Karl B
University of Arizona College of Medicine, Tucson, AZ, United States.
University of Arizona Sarver Heart Center, Tucson, AZ, United States.
Resusc Plus. 2021 Feb 6;5:100083. doi: 10.1016/j.resplu.2021.100083. eCollection 2021 Mar.
Cardiac arrest is an important public health concern, affecting an estimated 356,500 people in the out-of-hospital setting and 209,000 people in the in-hospital setting each year. The causes of cardiac arrest include acute coronary syndromes, pulmonary embolism, dyskalemia, respiratory failure, hypovolemia, sepsis, and poisoning among many others. In order to tackle the enormous issue of high mortality among sufferers of cardiac arrest, ongoing research has been seeking improved treatment protocols and novel therapies. One of the mechanical devices that has been increasingly utilized for cardiac arrest is venoarterial extracorporeal membrane oxygenation (VA-ECMO). Presently there is only one published randomized controlled trial examining the use of VA-ECMO as part of cardiopulmonary resuscitation (CPR), a process referred to as extracorporeal cardiopulmonary resuscitation (ECPR). Recently there has been significant progress in providing ECPR for refractory cardiac arrest patients. This narrative review seeks to outline the use of ECPR for both in-hospital and out-of-hospital cardiac arrest, as well as provide information on the expected outcomes associated with its use.
心脏骤停是一个重要的公共卫生问题,估计每年院外环境中有356,500人、院内环境中有209,000人受到影响。心脏骤停的原因包括急性冠状动脉综合征、肺栓塞、低钾血症、呼吸衰竭、血容量不足、败血症和中毒等多种情况。为了解决心脏骤停患者高死亡率这一巨大问题,正在进行的研究一直在寻求改进治疗方案和新型疗法。越来越多地用于心脏骤停的一种机械设备是静脉-动脉体外膜肺氧合(VA-ECMO)。目前只有一项已发表的随机对照试验研究了将VA-ECMO用作心肺复苏(CPR)的一部分,这一过程称为体外心肺复苏(ECPR)。最近在为难治性心脏骤停患者提供ECPR方面取得了重大进展。这篇叙述性综述旨在概述ECPR在院内和院外心脏骤停中的应用,并提供与其使用相关的预期结果的信息。