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. 2024 Dec 2;60(12):1979.
doi: 10.3390/medicina60121979.

Establishing an Extracorporeal Cardiopulmonary Resuscitation Program

Pietro Bertini  1 , Fabio Sangalli  2 , Paolo Meani  3 , Alberto Marabotti  4 , Antonio Rubino  5 , Sabino Scolletta  6 , Valentina Ajello  7 , Tommaso Aloisio  8 , Massimo Baiocchi  9 , Fabrizio Monaco  10 , Marco Ranucci  8 , Cristina Santonocito  11 , Simona Silvetti  12 , Filippo Sanfilippo  13   14 , Gianluca Paternoster  15 ; ITACTAIC
Affiliations

Establishing an Extracorporeal Cardiopulmonary Resuscitation Program

Pietro Bertini et al. Medicina (Kaunas). .

Abstract

Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective ECPR requires precise patient selection, rapid mobilization of a multidisciplinary team, and skilled cannulation techniques. Establishing a program necessitates a cohesive ECMO system that promotes interdisciplinary collaboration, which is essential for managing acute cardiogenic shock and severe pulmonary failure. ECPR is suited for selected patients, emphasizing the need to optimize every step of cardiac arrest management-from public education to advanced post-resuscitation care. The flexibility of ECMO teams allows them to manage various emergencies such as cardiogenic shock, massive pulmonary embolism, and severe asthma, showcasing the program's adaptability. Launching an ECPR program involves addressing logistical, financial, and organizational challenges. This includes gaining administrative approval, assembling a diverse team, and crafting detailed protocols and training regimens. The development process entails organizing teams, refining protocols, and training extensively to ensure operational readiness. A systematic approach to building an ECPR program involves establishing a team, defining patient selection criteria, and evaluating caseloads. Critical elements like patient transport protocols and anticoagulation management are vital for the program's success. In conclusion, initiating an ECPR program demands thorough planning, collaborative effort across specialties, and ongoing evaluation to improve outcomes in critical cardiac emergencies. This guide offers practical insights to support institutions in navigating the complexities of ECPR program development and maintenance.

Keywords: ECLS; ECMO; ECPR; cardiac arrest; critical care.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic drawing of roles and procedures during an ECPR cannulation.
See this image and copyright information in PMC

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