Discuss the role of extracorporeal cardiopulmonary resuscitation (ECPR) in cardiac arrest.
Include in your answer, the rationale for its use, the advantages, disadvantages, and appropriate patient selection.
ECPR has never been seen in the CICM exams until this paper.
age 12-70 years
AND meets ALL of the following criteria:
the cardiac arrest is likely to be of primary cardiac or respiratory cause
the cardiac arrest was witnessed by a bystander or paramedic or hospital staff member
chest compressions commenced within 10 minutes
initial cardiac rhythm of ventricular fibrillation (VF)
immediate availability of a mechanical CPR device with paramedic staff
the cardiac arrest duration (collapse to arrival at ED) has been < 60minutes
OR meets ONE of the following criteria:
Severe hypothermia (<32°C) due to accidental exposure
Severe overdose with β-blockers, tricyclic antidepressants, digoxin or other agents causing profound reversible myocardial depression and/or cardiac rhythm disturbance
Any other cause where there is likely to be reversibility of the cardiac arrest if an artificial circulation can be provided (e.g. massive pulmonary embolism)
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