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Review
. 2018 Mar 27;26(1):21.
doi: 10.1186/s13049-018-0489-y.

Pre-hospital extra-corporeal cardiopulmonary resuscitation

Ben Singer  1   2   3 , Joshua C Reynolds  4 , David J Lockey  5 , Ben O'Brien  6   7   8
Affiliations
Review

Pre-hospital extra-corporeal cardiopulmonary resuscitation

Ben Singer et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest compressions. Hospital-based ECPR is currently offered to selected OHCA patients in specialized centres. The interval between collapse and restoration of circulation is inversely associated with good clinical outcomes after ECPR. Pre-hospital delivery of ECPR concurrent with conventional resuscitation is one approach to shortening this interval and improving outcomes after OHCA. This article examines the background and rationale for pre-hospital ECPR; summarises the findings of a literature search for published evidence; and considers candidate selection, logistics, and complications for this complex intervention.

Keywords: Extracorporeal cardiopulmonary resuscitation; Extracorporeal life support; Extracorporeal membrane oxygenation; Pre-hospital.

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Conflict of interest statement

Authors’ information

BS: Consultant in Intensive Care Medicine, ECMO and Anaesthesia, Barts Heart Centre.

Consultant in Pre-Hospital Care, Barts Health and London’s Air Ambulance.

Honorary Senior Clinical Lecturer, William Harvey Institute, Queen Mary University.

Emeritus Kent, Surrey and Sussex Air Ambulance.

JCR: Assistant Professor of Emergency Medicine at Michigan State University (United States). Editorial Board for Resuscitation. Member of the ILCOR Advanced Life Support Task Force.

DL: Consultant in Intensive Care Medicine, Southmead Hospital Bristol, UK. Consultant in Pre-hospital Care, Bartshealth NHS Trust and Londons Air Ambulance. Hon. Professor Bristol University & Queen Mary University London.

BOB: Clinical Director Department of Perioperative Medicine, St Bartholomew’s Hospital, London, UK.

Consultant in Intensive Care Medicine and Cardiac Anaesthesia, Barts Heart Centre, Reader, William Harvey Research Institute, Privatdozent, Charité University Berlin and Berlin Heart Centre Emeritus London Air Ambulance and Sydney Aeromedical Retrieval Service Executive Council member, European Association of Cardiothoracic Anaesthetists.

Member of the Outcomes Research Consortium.

NIHR Emergency and Acute Care HTA Panel member.

MD, PhD (habil), FRCA, FFICM, MHBA.

Ethics approval and consent to participate

Not applicable

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

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