Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR)

Guido Michels1, Tobias Wengenmayer2, Christian Hagl3, Christian Dohmen4, Bernd W. Böttiger5, Johann Bauersachs6, Andreas Markewitz7, Adrian Bauer6, Jan‐Thorsten Gräsner8, Roman Pfister1, Alexander Ghanem9, Hans-Jörg Busch10, U. Kreimeier11, Andreas Beckmann12, Matthias Fischer13, Clemens Kill14, Uwe Janssens15, Stefan Kluge16, F. Born3, Hans Martin Hoffmeister17, Michael Preusch18, Udo Boeken19, Reimer Riessen20, Holger Thiele21
1Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
2Klinik für Kardiologie und Angiologie I, Universitäts-Herzzentrum Freiburg – Bad Krozingen, Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
3Herzchirurgische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians-Universität, München, Deutschland
4LVR-Klinik Bonn, Bonn, Deutschland
5Klinik für Anästhesiologie und Operative Intensivmedizin, Universität zu Köln, Köln, Deutschland
6Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
7Bendorf, Deutschland
8Institut für Rettungs- und Notfallmedizin, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
9Abteilung Kardiologie, II. Medizinische Klinik, Asklepios Klinik St. Georg, Hamburg, Deutschland
10Universitäts-Notfallzentrum, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
11Klinik für Anästhesiologie, Klinikum der Universität München, Ludwig-Maximilians-Universität, München, Deutschland
12Herzzentrum Duisburg, Klinik für Herz- und Gefäßchirurgie, Evangelisches Krankenhaus Niederrhein, Duisburg, Deutschland
13Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, ALB FILS KLINIKEN GmbH, Klinik am Eichert, Göppingen, Deutschland
14Zentrum für Notfallmedizin, Universitätsmedizin Essen, Essen, Deutschland
15Klinik für Innere Medizin und Intensivmedizin, St.-Antonius-Hospital, Eschweiler, Deutschland
16Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
17Klinik für Kardiologie und Allgemeine Innere Medizin, Städtisches Klinikum Solingen gGmbH, Solingen, Deutschland
18Zentrum für Innere Medizin, Klinik für Kardiologie, Angiologie und Pneumologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
19Klinik für Kardiovaskuläre Chirurgie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
20Department für Innere Medizin, Internistische Intensivstation, Universitätsklinikum Tübingen, Tübingen, Deutschland
21Klinik für Innere Medizin/Kardiologie, Herzzentrum Leipzig – Universitätsklinik, Leipzig, Deutschland

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Atwood C, Eisenberg MS, Herlitz J, Rea TD (2005) Incidence of EMS-treated out-of-hospital cardiac arrest in Europe. Resuscitation 67(1):75–80

Go AS, Mozaffarian D, Roger VL et al (2014) Executive summary: heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation 129(3):399–410

Hawkes C, Booth S, Ji C et al (2017) Epidemiology and outcomes from out-of-hospital cardiac arrests in England. Resuscitation 110:133–140

Spangenberg T, Schewel J, Dreher A et al (2018) Health related quality of life after extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest. Resuscitation 127:73–78

Kuisma M, Alaspää A (1997) Out-of-hospital cardiac arrests of non-cardiac origin. Epidemiology and outcome. Eur Heart J 18(7):1122–1128

Hess EP, Campbell RL, White RD (2007) Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin. Resuscitation 72(2):200–206

Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: Incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245

Link MS, Berkow LC, Kudenchuk PJ et al (2015) Part 7: advanced cardiovascular life support – 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 132(Suppl 2):S444–S464

Karam N, Marijon E, Dumas F et al (2017) Characteristics and outcomes of out-of-hospital sudden cardiac arrest according to the time of occurrence. Resuscitation 116:16–21

Soar J, Nolan JP, Böttiger BW et al (2015) European Resuscitation Council guidelines for resuscitation 2015 Section 3. Adult advanced life support. Resuscitation 95:100–147

Kim SJ, Kim HJ, Lee HY et al (2016) Comparing extracorporeal cardiopulmonary resuscitation with conventional cardiopulmonary resuscitation: a meta-analysis. Resuscitation 103:106–116

Vdovin N, Günther SPW, de Waha S et al (2017) Early risk stratification in patients with cardiogenic shock complicating acute myocardial infarction treated with extracorporeal life support and primary percutaneous coronary intervention. JACC Cardiovasc Interv 10(23):2469–2471

Chen YS, Lin JW, Yu HY et al (2008) Cardiopulmonary resuscitation with assisted extracorporeal life support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet 372:554–561

Wang CH, Chou NK, Becker LB et al (2014) Improved outcome of extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest – a comparison with that for extracorporeal rescue for in-hospital cardiac arrest. Resuscitation 85(9):1219–1224

Fagnoul D, Combes A, De Backer D (2014) Extracorporeal cardiopulmonary resuscitation. Curr Opin Crit Care 20(3):259–265

Blumenstein J, Leick J, Liebetrau C et al (2016) Extracorporeal life support in cardiovascular patients with observed refractory in-hospital cardiac arrest is associated with favourable short and long-term outcomes: a propensity-matched analysis. Eur Heart J Acute Cardiovasc Care 5(7):13–22

Spangenberg T, Meincke F, Brooks S et al (2016) „Shock and Go?“ extracorporeal cardio-pulmonary resuscitation in the golden-hour of ROSC. Catheter Cardiovasc Interv 88(5):691–696

Combes A, Brodie D, Chen YS et al (2017) The ICM research agenda on extracorporeal life support. Intensive Care Med 43(9):1306–1318

Debaty G, Babaz V, Durand M et al (2017) Prognostic factors for extracorporeal cardiopulmonary resuscitation recipients following out-of-hospital refractory cardiac arrest. A systematic review and meta-analysis. Resuscitation 112:1–10

Conrad SA, Rycus PT (2017) Extracorporeal membrane oxygenation for refractory cardiac arrest. Ann Card Anaesth 20(Supplement):S4–S10

Richardson AS, Schmidt M, Bailey M et al (2017) ECMO Cardio-Pulmonary Resuscitation (ECPR), trends in survival from an international multicentre cohort study over 12-years. Resuscitation 112:34–40

Haas NL, Coute RA, Hsu CH et al (2017) Descriptive analysis of extracorporeal cardiopulmonary resuscitation following out-of-hospital cardiac arrest-an ELSO registry study. Resuscitation 119:56–62

Ouweneel DM, Schotborgh JV, Limpens J et al (2016) Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis. Intensive Care Med 42:1922–1934

Trummer G, Bein B, Buerke M et al (2011) Standardized terminology of mechanical heart, lung and circulatory assist devices: a recommendation of the section „heart and circulation“ of the German Interdisciplinary Association of Critical Care Medicine. Appl Cardiopulm Pathophysiol 15:181–182

ELSO (2013) ECPR supplement to the ELSO general guidelines. Version 1.3 ( https://www.elso.org/Portals/0/IGD/Archive/FileManager/6713186745cusersshyerdocumentselsoguidelinesforecprcases1.3.pdf )

Günther S, Born F, Buchholz S et al (2018) Patienten unter Reanimation: Kandidaten für „Extracorporeal Life Support“? Z Herz Thorax Gefäßchir 32:133–140

Wengenmayer T, Rombach S, Ramshorn F et al (2017) Influence of low-flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR). Crit Care 21(1):157

Kuroki N, Abe D, Iwama T et al (2017) Association between delay to coronary reperfusion and outcome in patients with acute coronary syndrome undergoing extracorporeal cardiopulmonary resuscitation. Resuscitation 114:1–6

Abrams D, Garan AR, Abdelbary A et al (2018) Position paper for the organization of ECMO programs for cardiac failure in adults. Intensive Care Med. https://doi.org/10.1007/s00134-018-5064-5

Yannopoulos D, Bartos JA, Raveendran G et al (2017) Coronary artery disease in patients with out-of-hospital refractory ventricular fibrillation cardiac arrest. J Am Coll Cardiol 70(9):1109–1117

Hayashida K, Suzuki M, Yonemoto N et al (2017) Early lactate clearance is associated with improved outcomes in patients with postcardiac arrest syndrome: a prospective, multicenter observational study (SOS-KANTO 2012 study). Crit Care Med 45(6):e559–e566

Slottosch I, Liakopoulos O, Kuhn E et al (2017) Lactate and lactate clearance as valuable tool to evaluate ECMO therapy in cardiogenic shock. J Crit Care 42:35–41

Momiyama Y, Yamada W, Miyata K et al (2017) Prognostic values of blood pH and lactate levels in patients resuscitated from out-of-hospital cardiac arrest. Acute Med Surg 4(1):25–30

Zeserson E, Goodgame B, Hess JD et al (2018) Correlation of venous blood gas and pulse oximetry with arterial blood gas in the undifferentiated critically ill patient. J Intensive Care Med 33(3):176–181

Siegenthaler W (2005) Differentialdiagnose, 19. Aufl. Thieme, Stuttgart

Geisler AC, Söffker G, Breunig F et al (2014) Der besondere Fall-Optimale Rettungskette. Hamb Arztebl 68(10):44–46

Hohmann C, Pfister R, Michels G (2018) Are the initial pH and the lactate values after cardiopulmonary resuscitation always crucial? Med Klin Intensivmed Notfmed. https://doi.org/10.1007/s00063-018-0432-z

Shin J, Lim YS, Kim K et al (2017) Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study. Crit Care 21(1):322

Gil E, Na SJ, Ryu JA et al (2017) Association of body mass index with clinical outcomes for in-hospital cardiac arrest adult patients following extracorporeal cardiopulmonary resuscitation. PLoS ONE 12(4):e176143

Kang SB, Kim KS, Suh GJ et al (2017) Long-term survival of out-of-hospital cardiac arrest patients with malignancy. Am J Emerg Med 35(10):1457–1461

Sulzgruber P, Sterz F, Poppe M et al (2017) Age-specific prognostication after out-of-hospital cardiac arrest - the ethical dilemma between „life-sustaining treatment“ and „the right to die“ in the elderly. Eur Heart J Acute Cardiovasc Care 6(2):112–120

Pabst D, El-Banayosy A, Soleimani B, Brehm CE (2018) Predictors of survival for nonhighly selected patients undergoing resuscitation with extracorporeal membrane oxygenation after cardiac arrest. ASAIO J 64(3):368–374

Lorusso R, Gelsomino S, Parise O et al (2017) Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock in elderly patients: trends in application and outcome from the Extracorporeal Life Support Organization (ELSO) Registry. Ann Thorac Surg 104(1):62–69

Riggs KR, Becker LB, Sugarman J (2015) Ethics in the use of extracorporeal cardiopulmonary resuscitation in adults. Resuscitation 91:73–75

Mancini ME, Diekema DS, Hoadley TA et al (2015) Part 3: ethical issues: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 132(18 Suppl 2):S383–S396

Meltzer EC, Ivascu NS, Stark M et al (2016) A survey of physicians’ attitudes toward decision-making authority for initiating and withdrawing VA-ECMO: results and ethical implications for shared decision making. J Clin Ethics 27(4):281–289

Makdisi T, Makdisi G (2017) Extra-corporeal membrane oxygenation support: ethical dilemmas. Ann Transl Med 5(5):112

Niecke A, Schneider G, Hartog CS, Michels G (2017) Traumatized relatives of intensive care patients. Med Klin Intensivmed Notfmed 112(7):612–617

Michels G, Thiele H, Kluge S, Pfister R (2017) Are there any prognostic predictors for extracorporeal cardiopulmonary resuscitation (ECPR) in case of out-of-hospital cardiac arrest? Med Klin Intensivmed Notfmed 112(7):634–636

Stiell IG, Nichol G, Leroux BG et al (2011) Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med 365(9):787–797

Goslar T, Knafelj R, Radsel P et al (2016) Emergency percutaneous implantation of veno-arterial extracorporeal membrane oxygenation in the catheterisation laboratory. EuroIntervention 12(12):1465–1472

Kashiura M, Sugiyama K, Tanabe T, Akashi A, Hamabe Y (2017) Effect of ultrasonography and fluoroscopic guidance on the incidence of complications of cannulation in extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a retrospective observational study. BMC Anesthesiol 17(1):4

Voicu S, Henry P, Malissin I et al (2018) Improving cannulation time for extracorporeal life support in refractory cardiac arrest of presumed cardiac cause – comparison of two percutaneous cannulation techniques in the catheterization laboratory in a center without on-site cardiovascular surgery. Resuscitation 122:69–75

Reynolds JC, Callaway CW, El Khoudary SR et al (2009) Coronary angiography predicts improved outcome following cardiac arrest: propensity-adjusted analysis. J Intensive Care Med 24(3):179–186

Dumas F, Cariou A, Manzo-Silberman S et al (2010) Immediate percutaneous coronary intervention is associated with better survival after out-of-hospital cardiac arrest: insights from the PROCAT (Parisian Region Out of hospital Cardiac ArresT) registry. Circ Cardiovasc Interv 3(3):200–207

Kragholm K, Malta Hansen C, Dupre ME et al (2017) Direct transport to a percutaneous cardiac intervention center and outcomes in patients with out-of-hospital cardiac arrest. Circ Cardiovasc Qual Outcomes 10(6):e3414. https://doi.org/10.1161/CIRCOUTCOMES.116.003414

Scholz KH, Andresen D, Böttiger BW et al (2017) Quality indicators and structural requirements for cardiac arrest centers-German Resuscitation Council (GRC). Kardiologe 11:205–208

Jarosz A, Darocha T, Kosiński S et al (2017) Profound accidental hypothermia: systematic approach to active recognition and treatment. ASAIO J 63(3):e26–e30

Beckmann A, Benk C, Beyersdorf F et al (2011) Position article for the use of extracorporeal life support in adult patients. Eur J Cardiothorac Surg 40(3):676–680

Combes A, Brodie D, Bartlett R et al (2014) Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med 190(5):488–496

Dirnberger D, Fiser R, Harvey C et al (2015) Extracorporeal Life Support Organization (ELSO), guidelines for ECMO transport. https://www.elso.org/resources/guidelines.aspx

Broman LM, Frenckner B (2016) Transportation of critically ill patients on extracorporeal membrane oxygenation. Front Pediatr 4:63

Michels G, Zinke H, Möckel M et al (2017) Recommendations for education in ultrasound in medical intensive care and emergency medicine: position paper of DGIIN, DEGUM and DGK. Med Klin Intensivmed Notfmed 112(4):314–319

Zhang Z (2017) Echocardiography for patients undergoing extracorporeal cardiopulmonary resuscitation: a primer for intensive care physicians. J Intensive Care 5:15

Price S, Platz E, Cullen L et al (2017) Expert consensus document: echocardiography and lung ultrasonography for the assessment and management of acute heart failure. Nat Rev Cardiol 14(7):427–440

Nolan JP, Hazinski MF, Aickin R et al (2015) Part 1: executive summary: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation 95:e1–e31

Olasveengen TM, de Caen AR, Mancini ME et al (2017) 2017 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations summary. Circulation 136(23):e424–e440

Perkins GD, Olasveengen TM, Maconochie I et al (2018) European Resuscitation Council guidelines for resuscitation: 2017 update. Resuscitation 123:43–50

Swol J, Belohlávek J, Haft JW et al (2016) Conditions and procedures for in-hospital extracorporeal life support (ECLS) in cardiopulmonary resuscitation (CPR) of adult patients. Perfusion 31(3):182–188

Leick J, Liebetrau C, Szardien S et al (2013) Door-to-implantation time of extracorporeal life support systems predicts mortality in patients with out-of-hospital cardiac arrest. Clin Res Cardiol 102(9):661–669

Nanjayya VB, Murphy D (2015) Ultrasound guidance for extra-corporeal membrane oxygenation general guidelines ( https://www.elso.org/Portals/0/Files/elso_Ultrasoundguideance_ecmogeneral_guidelines_May2015.pdf )

Ahn HJ, Lee JW, Joo KH et al (2018) Point-of-care ultrasound-guided percutaneous cannulation of extracorporeal membrane oxygenation: make it simple. J Emerg Med 54(4):507–513

Beck L, Burg MC, Heindel W, Schülke C (2017) Extracorporeal membrane oxygenation in adults – variants, complications during therapy, and the role of radiological imaging. Rofo 189(2):119–127

Pang PY, Wee GH, Hoo AE et al (2016) Therapeutic hypothermia in adult patients receiving extracorporeal life support: early results of a randomized controlled study. J Cardiothorac Surg 11:43

Spartera M, Jabbour RJ, Chiarito M, De Bonis M, Pappalardo F (2017) Stepwise use of circulatory support devices in a patient refractory to cardiopulmonary resuscitation. Cardiovasc Revasc Med 18(6):447–449

Tepper S, Masood MF, Baltazar Garcia M et al (2017) Left ventricular unloading by Impella device versus surgical vent during extracorporeal life support. Ann Thorac Surg 104(3):861–867

Ibanez B, James S, Agewall S et al (2018) 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 39(2):119–177 (The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC))

Johnson B, Runyon M, Weekes A, Pearson D (2017) Team-focused cardiopulmonary resuscitation: prehospital principles adapted for emergency department cardiac arrest resuscitation. J Emerg Med. https://doi.org/10.1016/j.jemermed.2017.08.065

Barbaro RP, Odetola FO, Kidwell KM et al (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(8):894–901