Department of Cardiology, Hospital AGEL-Trinec Podlesi a.s., 739 61 Trinec, Czech Republic.
Third Faculty of Medicine, Charles University, 128 08 Prague, Czech Republic.
Medicina (Kaunas). 2024 Sep 4;60(9):1444. doi: 10.3390/medicina60091444.
Extracorporeal cardiopulmonary resuscitation (ECPR) is an advanced technique using extracorporeal membrane oxygenation (ECMO) to support patients with refractory cardiac arrest. Age significantly influences ECPR outcomes, with younger patients generally experiencing better survival and neurological outcomes due to many aspects. This review explores the impact of age on ECPR effectiveness, emphasizing the need to consider age alongside other clinical factors in patient selection. Survival rates differ notably between in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA), highlighting the importance of rapid intervention. The potential of artificial intelligence to develop predictive models for ECPR outcomes is discussed, aiming to improve decision-making. Ethical considerations around age-based treatment decisions are also addressed. This review advocates for a balanced approach to ECPR, integrating clinical and ethical perspectives to optimize patient outcomes across all age groups.
体外心肺复苏术（ECPR）是一种使用体外膜氧合（ECMO）支持难治性心搏骤停患者的先进技术。年龄对 ECPR 结果有显著影响，由于许多方面的原因，年轻患者的总体生存率和神经功能结局较好。本综述探讨了年龄对 ECPR 效果的影响，强调在患者选择中应考虑年龄与其他临床因素相结合。院内心搏骤停（IHCA）和院外心搏骤停（OHCA）之间的生存率差异显著，突出了快速干预的重要性。讨论了人工智能在开发 ECPR 结果预测模型方面的潜力，旨在改善决策制定。还讨论了基于年龄的治疗决策的伦理考虑。本综述主张采用平衡的方法进行 ECPR，综合临床和伦理观点，优化所有年龄段患者的结局。
