Department of Emergency Medicine.
Department of Anesthesiology.
Curr Opin Crit Care. 2022 Jun 1;28(3):276-283. doi: 10.1097/MCC.0000000000000944.
Extracorporeal cardiopulmonary resuscitation (ECPR) is an invasive and resource-intensive therapy used to care for patients with refractory cardiac arrest. In this review, we highlight considerations for the establishment of an ECPR system of care for patients suffering refractory out-of-hospital cardiac arrest (OHCA).
ECPR has been shown to improve neurologically favorable outcomes in patients with refractory cardiac arrest in numerous studies, including a single randomized control trial. Successful ECPR programs are typically part of a comprehensive system of care that optimizes all phases of OHCA management. Given the resource-intensive and time-sensitive nature of ECPR, patient selection criteria, timing of ECPR, and location must be well defined. Many knowledge gaps remain within ECPR systems of care, postcardiac arrest management, and neuroprognostication strategies for ECPR patients.
To be consistently successful, ECPR must be a part of a comprehensive OHCA system of care that optimizes all phases of cardiac arrest management. Future investigation is needed for the knowledge gaps that remain.
体外心肺复苏（ECPR）是一种侵入性的、资源密集型的治疗方法，用于治疗难治性心搏骤停的患者。在这篇综述中，我们强调了为患有难治性院外心脏骤停（OHCA）的患者建立 ECPR 治疗系统时需要考虑的因素。
多项研究表明，ECPR 可改善难治性心脏骤停患者的神经功能预后，包括一项随机对照试验。成功的 ECPR 项目通常是全面心脏骤停管理系统的一部分，可优化 OHCA 管理的所有阶段。鉴于 ECPR 的资源密集型和时间敏感性，患者选择标准、ECPR 的时机和地点必须明确界定。ECPR 治疗系统、心脏骤停后管理以及 ECPR 患者的神经预后策略仍存在许多知识空白。
为了始终取得成功，ECPR 必须是全面 OHCA 治疗系统的一部分，该系统可优化心脏骤停管理的所有阶段。需要对仍然存在的知识空白进行进一步的研究。
