-
Something wrong with this record ?
Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications
D. Abrams, G. MacLaren, R. Lorusso, S. Price, D. Yannopoulos, L. Vercaemst, J. Bělohlávek, FS. Taccone, N. Aissaoui, K. Shekar, AR. Garan, N. Uriel, JE. Tonna, JS. Jung, K. Takeda, YS. Chen, AS. Slutsky, A. Combes, D. Brodie
Language English Country United States
Document type Journal Article, Review
NLK
ProQuest Central
from 1997-01-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2000-01-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 1997-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 1997-01-01 to 1 year ago
- MeSH
- Cost-Benefit Analysis MeSH
- Adult MeSH
- Cardiopulmonary Resuscitation * methods MeSH
- Humans MeSH
- Extracorporeal Membrane Oxygenation * methods MeSH
- Out-of-Hospital Cardiac Arrest * therapy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Rates of survival with functional recovery for both in-hospital and out-of-hospital cardiac arrest are notably low. Extracorporeal cardiopulmonary resuscitation (ECPR) is emerging as a modality to improve prognosis by augmenting perfusion to vital end-organs by utilizing extracorporeal membrane oxygenation (ECMO) during conventional CPR and stabilizing the patient for interventions aimed at reversing the aetiology of the arrest. Implementing this emergent procedure requires a substantial investment in resources, and even the most successful ECPR programs may nonetheless burden healthcare systems, clinicians, patients, and their families with unsalvageable patients supported by extracorporeal devices. Non-randomized and observational studies have repeatedly shown an association between ECPR and improved survival, versus conventional CPR, for in-hospital cardiac arrest in select patient populations. Recently, randomized controlled trials suggest benefit for ECPR over standard resuscitation, as well as the feasibility of performing such trials, in out-of-hospital cardiac arrest within highly coordinated healthcare delivery systems. Application of these data to clinical practice should be done cautiously, with outcomes likely to vary by the setting and system within which ECPR is initiated. ECPR introduces important ethical challenges, including whether it should be considered an extension of CPR, at what point it becomes sustained organ replacement therapy, and how to approach patients unable to recover or be bridged to heart replacement therapy. The economic impact of ECPR varies by health system, and has the potential to outstrip resources if used indiscriminately. Ideally, studies should include economic evaluations to inform health care systems about the cost-benefits of this therapy.
Adult Intensive Care Services Prince Charles Hospital Brisbane Australia
Adult Intensive Care Unit Royal Brompton Hospital London UK
Bond University Gold Coast Australia
Center for Acute Respiratory Failure Columbia University Irving Medical Center New York NY USA
Center for Resuscitation Medicine University of Minnesota Medical School Minneapolis MN USA
Department of Intensive Care Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
Department of Perfusion University Hospital Gasthuisberg Leuven Belgium
Department of Surgery National Taiwan University Hospital Taipei Taiwan
Department of Thoracic and Cardiovascular Surgery Korea University Medicine Seoul Republic of Korea
Division of Cardiac Vascular and Thoracic Surgery Columbia University Medical Center New York USA
Division of Emergency Medicine Department of Surgery University of Utah Health Salt Lake City UT USA
Institute of Cardiometabolism and Nutrition Sorbonne Université Paris France
Keenan Research Center St Michael's Hospital Li Ka Shing Knowledge Institute Toronto Canada
National Heart and Lung Institute Imperial College London UK
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc22011503
- 003
- CZ-PrNML
- 005
- 20220506125948.0
- 007
- ta
- 008
- 220425s2022 xxu f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1007/s00134-021-06514-y $2 doi
- 035 __
- $a (PubMed)34505911
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a xxu
- 100 1_
- $a Abrams, Darryl $u Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 622 W168th St., PH 8E, Room 101, New York, NY, 10032, USA $u Center for Acute Respiratory Failure, Columbia University Irving Medical Center, New York, NY, USA $1 https://orcid.org/0000000190733897
- 245 10
- $a Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications / $c D. Abrams, G. MacLaren, R. Lorusso, S. Price, D. Yannopoulos, L. Vercaemst, J. Bělohlávek, FS. Taccone, N. Aissaoui, K. Shekar, AR. Garan, N. Uriel, JE. Tonna, JS. Jung, K. Takeda, YS. Chen, AS. Slutsky, A. Combes, D. Brodie
- 520 9_
- $a Rates of survival with functional recovery for both in-hospital and out-of-hospital cardiac arrest are notably low. Extracorporeal cardiopulmonary resuscitation (ECPR) is emerging as a modality to improve prognosis by augmenting perfusion to vital end-organs by utilizing extracorporeal membrane oxygenation (ECMO) during conventional CPR and stabilizing the patient for interventions aimed at reversing the aetiology of the arrest. Implementing this emergent procedure requires a substantial investment in resources, and even the most successful ECPR programs may nonetheless burden healthcare systems, clinicians, patients, and their families with unsalvageable patients supported by extracorporeal devices. Non-randomized and observational studies have repeatedly shown an association between ECPR and improved survival, versus conventional CPR, for in-hospital cardiac arrest in select patient populations. Recently, randomized controlled trials suggest benefit for ECPR over standard resuscitation, as well as the feasibility of performing such trials, in out-of-hospital cardiac arrest within highly coordinated healthcare delivery systems. Application of these data to clinical practice should be done cautiously, with outcomes likely to vary by the setting and system within which ECPR is initiated. ECPR introduces important ethical challenges, including whether it should be considered an extension of CPR, at what point it becomes sustained organ replacement therapy, and how to approach patients unable to recover or be bridged to heart replacement therapy. The economic impact of ECPR varies by health system, and has the potential to outstrip resources if used indiscriminately. Ideally, studies should include economic evaluations to inform health care systems about the cost-benefits of this therapy.
- 650 _2
- $a dospělí $7 D000328
- 650 12
- $a kardiopulmonální resuscitace $x metody $7 D016887
- 650 _2
- $a analýza nákladů a výnosů $7 D003362
- 650 12
- $a mimotělní membránová oxygenace $x metody $7 D015199
- 650 _2
- $a lidé $7 D006801
- 650 12
- $a zástava srdce mimo nemocnici $x terapie $7 D058687
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a přehledy $7 D016454
- 700 1_
- $a MacLaren, Graeme $u Cardiothoracic Intensive Care Unit, Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore, Singapore
- 700 1_
- $a Lorusso, Roberto $u Cardiothoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
- 700 1_
- $a Price, Susanna $u Adult Intensive Care Unit, Royal Brompton Hospital, London, UK $u National Heart and Lung Institute, Imperial College, London, UK
- 700 1_
- $a Yannopoulos, Demetris $u Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- 700 1_
- $a Vercaemst, Leen $u Department of Perfusion, University Hospital Gasthuisberg, Leuven, Belgium
- 700 1_
- $a Bělohlávek, Jan $u Second Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- 700 1_
- $a Taccone, Fabio S $u Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- 700 1_
- $a Aissaoui, Nadia $u Intensive Care Unit, APHP, Hopital Européen Georges Pompidou, Inserm U 970, Université de Paris, Paris, France
- 700 1_
- $a Shekar, Kiran $u Adult Intensive Care Services, Prince Charles Hospital, Brisbane, Australia $u University of Queensland, Brisbane, Australia $u Bond University, Gold Coast, Australia
- 700 1_
- $a Garan, A Reshad $u Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- 700 1_
- $a Uriel, Nir $u Division of Cardiology, Department of Medicine, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY, USA
- 700 1_
- $a Tonna, Joseph E $u Division of Cardiothoracic Surgery, Department of Surgery, University of Utah Health, Salt Lake City, UT, USA $u Division of Emergency Medicine, Department of Surgery, University of Utah Health, Salt Lake City, UT, USA
- 700 1_
- $a Jung, Jae Seung $u Department of Thoracic and Cardiovascular Surgery, Korea University Medicine, Seoul, Republic of Korea
- 700 1_
- $a Takeda, Koji $u Division of Cardiac, Vascular and Thoracic Surgery, Columbia University Medical Center, New York, USA
- 700 1_
- $a Chen, Yih-Sharng $u Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- 700 1_
- $a Slutsky, Arthur S $u Keenan Research Center, St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada $u Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, Canada
- 700 1_
- $a Combes, Alain $u Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris, France $u Service de Médecine Intensive-Réanimation, Hôpitaux Universitaires Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Institut de Cardiologie, Paris, France
- 700 1_
- $a Brodie, Daniel $u Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 622 W168th St., PH 8E, Room 101, New York, NY, 10032, USA. hdb5@cumc.columbia.edu $u Center for Acute Respiratory Failure, Columbia University Irving Medical Center, New York, NY, USA. hdb5@cumc.columbia.edu
- 773 0_
- $w MED00002258 $t Intensive care medicine $x 1432-1238 $g Roč. 48, č. 1 (2022), s. 1-15
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/34505911 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y p $z 0
- 990 __
- $a 20220425 $b ABA008
- 991 __
- $a 20220506125940 $b ABA008
- 999 __
- $a ok $b bmc $g 1789220 $s 1162701
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2022 $b 48 $c 1 $d 1-15 $e 20210910 $i 1432-1238 $m Intensive care medicine $n Intensive Care Med $x MED00002258
- LZP __
- $a Pubmed-20220425
