Extracorporeal Cardiopulmonary Resuscitation in Adults
Jan Bělohlávek, Jana Šmalcová
Abstract
Extracorporeal life support (ECLS) is an established mechanical support in cases of severe cardiac and/or respiratory failure. When used during cardiopulmonary resuscitation (CPR) (e.g., implanted during ongoing cardiac arrest [CA]), it is usually called extracorporeal cardiopulmonary resuscitation (ECPR). In other words, ECPR is for the use of ECLS in patients who remain in CA despite conventional CPR or when intermittent return of spontaneous circulation (ROSC) occurs, but repetitive CA reoccurs again. It is essential that ECPR is being used in refractory CA, when reasonable time has been used to try to achieve ROSC or where chance of obtaining and sustaining ROSC is low. ECPR provides mechanical support/replacement for failed circulation or gas exchange, whatever the reason for CA was. The prognosis of refractory CA is generally very poor; therefore, ECPR also bears a grave prognosis. However, in institutions with well-functioning ECPR programs, reasonable survival may be achieved.