Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jun;119(5):346-351.
doi: 10.1007/s00063-024-01131-1. Epub 2024 Apr 3.

[Open questions with respect to extracorporeal circulatory support 2024]

[Article in German]
J-M Kruse  1 , J Nee  2 , K-U Eckardt  2 , T Wengenmayer  3
Affiliations
Review

[Open questions with respect to extracorporeal circulatory support 2024]

[Article in German]
J-M Kruse et al. Med Klin Intensivmed Notfmed. 2024 Jun.

Abstract
in English, German

The use of extracorporeal circulatory support, both for cardiogenic shock and during resuscitation, still presents many unanswered questions. The inclusion and exclusion criteria for such a resource-intensive treatment must be clearly defined, considering that these criteria are directly associated with the type and location of treatment. For example, it is worth questioning the viability of an extracorporeal resuscitation program in areas where it is impossible to achieve low-flow times under 60 min due to local limitations. Additionally, the best approach for further treatment, including whether it is necessary to regularly relieve the left ventricle, must be explored. To find answers to some of these questions, large-scale, multicenter, randomized studies and registers must be performed. Until then this treatment must be carefully considered before use.

Die extrakorporale Kreislaufunterstützung, sowohl im kardiogenen Schock als auch unter Reanimation, stellt uns noch vor viele offene Fragen. Die Ein- und Ausschlusskriterien für eine so ressourcenintensive Behandlung müssen präzisiert werden. Mit diesen Kriterien hängen unmittelbar Art und Ort der Therapie zusammen. Macht ein Programm der extrakorporalen Reanimation Sinn, wenn aufgrund der örtlichen Gegebenheiten Low-flow-Zeiten von unter 60 min niemals erreicht werden können? Wie erfolgt die optimale weitere Therapie? Muss der linke Ventrikel regelmäßig entlastet werden? Einem Teil dieser Fragen werden wir in weiteren großen multizentrischen, randomisierten Studien und Registern näherkommen. Bis dahin bleibt uns der überlegte Einsatz dieser Therapie.

Keywords: Cardiac arrest; Extracorporeal cardiopulmonary resuscitation; Extracorporeal circulation/physiological complications; Shock, cardiogenic; Venting.

PubMed Disclaimer

References

Literatur

    1. Abrams D, Maclaren G, Lorusso R, Price S, Yannopoulos D, Vercaemst L, Bělohlávek J, Taccone FS, Aissaoui N, Shekar K, Garan AR, Uriel N, Tonna JE, Seung Jung J, Takeda K, Chen Y‑S, Slutsky AS, Combes A, Brodie D (2022) Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications. Intensive Care Med 48:1–15. https://doi.org/10.1007/s00134-021-06514-y - DOI - PubMed
    1. Alfalasi R, Downing J, Cardona S, Lowie BJ, Fairchild M, Chan C, Powell E, Pourmand A, Grazioli A, Tran QK (2022) A comparison between conventional and extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a systematic review and meta-analysis. Healthcare. https://doi.org/10.3390/HEALTHCARE10030591 - DOI - PubMed - PMC
    1. Barbaro RP, Odetola FO, Kidwell KM, Paden ML, Bartlett RH, Davis MM, Annich GM (2015) Association of hospital-level volume of extracorporeal membrane oxygenation cases and mortality: analysis of the extracorporeal life support organization registry. Am J Respir Crit Care Med 191:894–901. https://doi.org/10.1164/rccm.201409-1634OC - DOI - PubMed - PMC
    1. Bartos JA, Frascone RJ, Conterato M, Wesley K, Lick C, Sipprell K, Vuljaj N, Burnett A, Peterson BK, Simpson N, Ham K, Bruen C, Woster C, Haley KB, Moore J, Trigger B, Hodgson L, Harkins K, Kosmopoulos M, Aufderheide TP, Tolar J, Yannopoulos D (2020) The Minnesota mobile extracorporeal cardiopulmonary resuscitation consortium for treatment of out-of-hospital refractory ventricular fibrillation: Program description, performance, and outcomes. EClinicalMedicine. https://doi.org/10.1016/J.ECLINM.2020.100632 - DOI - PubMed - PMC
    1. Bartos JA, Grunau B, Carlson C, Duval S, Ripeckyj A, Kalra R, Raveendran G, John R, Conterato M, Frascone RJ, Trembley A, Aufderheide TP, Yannopoulos D (2020) Improved survival with extracorporeal cardiopulmonary resuscitation despite progressive metabolic derangement associated with prolonged resuscitation. Circulation 141:877–886. https://doi.org/10.1161/CIRCULATIONAHA.119.042173 - DOI - PubMed - PMC

LinkOut - more resources