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Lightning Strike-Induced Cardiac Arrest Managed With Extracorporeal Cardiopulmonary Resuscitation: A Case Report

Abstract Lightning strike injuries have a high mortality rate and frequently result in immediate cardiac arrest. Although extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for out-of-hospital cardiac arrest, its role..

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Prehospital extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest in goat with severe primary blast lung Injury-a pilot study

Abstract Background Although extracorporeal cardiopulmonary resuscitation (ECPR) has shown promise for refractory out-of-hospital cardiac arrest (CA), limited data exist regarding its application in cases involving severe primary blast lung injury..

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Trends and outcomes of cardiac arrest and extracorporeal membrane oxygenation during the COVID-19 pandemic in the United States

Abstract Background The COVID-19 Pandemic challenged the healthcare system worldwide, but its effect on outcomes of cardiac arrest (CA) and extracorporeal membrane oxygenation (ECMO) use are understudied. We examined trends..

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Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) may reduce mortality and improve neurological outcomes in patients with cardiac arrest. We updated our existing meta-analysis and trial sequential analysis to further evaluate..

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European Resuscitation Council Guidelines 2025 Special Circumstances in Resuscitation

Abstract These European Resuscitation Council (ERC) Guidelines 2025 on Special Circumstances in Resuscitation are based on the 2025 Consensus on Science with Treatment Recommendations (CoSTR) of the International Liaison Committee..

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Extracorporeal cardiopulmonary resuscitation in trauma patients: An analysis of the ELSO registry

Abstract Background Cardiac arrest in trauma patients can occur from traumatic or non-traumatic aetiologies. Traditionally, trauma has been regarded a contraindication for extracorporeal life support, particularly extracorporeal cardiopulmonary resuscitation (ECPR)...

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European Resuscitation Council Guidelines 2025

Abstract The 2025 European Resuscitation Council (ERC) Guidelines present the most up-to-date evidence-based guidelines for the practice of resuscitation across Europe. The ERC Guidelines 2025 are based on evidence produced..

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Organ Donation after Extracorporeal Cardiopulmonary Resuscitation: Clinical and Ethical Perspectives

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) has evolved into a life-saving therapy for select cardiac arrest patients, yet a growing body of evidence suggests it also holds promise as a bridge..

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Ice Water Drowning Survival After 147-Minute Submersion and 7 °C Hypothermic Circulatory Arrest

Abstract Background Young patients may survive accidental deep hypothermia with prolonged asystolic circulatory arrest because of protective effects of cold. Case Summary An 8-year-old boy fell through pond ice and..

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Implementing lean six sigma to optimize emergency extracorporeal cardiopulmonary resuscitation process management

Abstract Objective The aim of this study is to evaluate the effectiveness of lean six sigma management in optimizing the emergency extracorporeal cardiopulmonary resuscitation (ECPR) rescue process. Methods The existing..

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Extracorporeal CPR Performance Metrics in Adult In-Hospital Cardiac Arrest: A Stepwise and Evidence-Based Appraisal of the VA-ECMO Implementation Process

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is an established intervention for select patients experiencing refractory cardiac arrest. Among modifiable predictors of survival and neurologic recovery during ECPR implementation, timely restoration of..

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Incidence, Risk Factors, and Outcomes of Seizures in Extracorporeal Cardiopulmonary Resuscitation Patients: An Analysis of the Extracorporeal Life Support Organization…

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest is increasing in usage, but risk factors for seizures are largely unknown. We included adult ECPR patients in the Extracorporeal Life..

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Delayed neurological recovery in patients after extracorporeal resuscitation compared to conventional resuscitation. Implications for outcome assessment after cardiac arrest

Abstract Introduction Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for refractory cardiac arrest, with evidence suggesting improved outcomes when performed at experienced centres. Unlike conventional CPR (cCPR), eCPR patients..

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Is it Time to Upgrade Neuromonitoring in ECPR Recipients to Evaluate Cerebral Perfusion Imbalances Adequately?

Abstract Veno-arterial extracorporeal membrane oxygenation (ECMO) brings many monitoring pitfalls due to the countercurrent blood flow, which may create left ventricular overload and perfusion imbalances between the two cerebral hemispheres...

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Exploring the Association Between Early PaCO2 Correction Speed and Cerebrovascular Autoregulation in a Porcine Model of Extracorporeal Resuscitation

Abstract Background Prior clinical research demonstrated that rapid reduction in arterial carbon dioxide (PaCO2) levels during extracorporeal membrane oxygenation (ECMO) is associated with acute brain injury (ABI), which may be..

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Immediate post-ECPR management strategies in the prehospital and critical care transport medicine environments

Abstract Despite advancements in care, out-of-hospital cardiac arrest has a low survival rate. Extracorporeal cardiopulmonary resuscitation (ECPR) has shown improved outcomes in select cases, notably in the ARREST trial. However,..

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The cost-effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest: A Systematic Review

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest across the world, but its cost-effectiveness remains uncertain. We conducted this systematic review to assess the available..

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Extracorporeal Cardiopulmonary Resuscitation: Reviewing the Evidence and Exploring Its Equitable Implementation in the UK National Health Service

Abstract Cardiac arrest outcomes remain historically poor with survival to hospital discharge less than 2.2% in the UK (). Refractory cardiac arrest is characterized by a persistent loss of circulation..

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Extracorporeal and Conventional Cardiopulmonary Resuscitation and Low‐Flow Duration: Insights From a Nationwide Hospital‐Based Registry Study in Japan (JAAM‐OHCA Registry)

Abstract Background The optimal low‐flow duration (LFD) for extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) remains unclear. We evaluated the impact of LFD on neurological outcomes based on..

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Is the use of ECPR for OHCA ready for broad implementation?

Abstract The use of Extracorporeal Cardiopulmonary Resuscitation (ECPR) in cases of cardiac arrest is increasing, as addressed in the number of cases in the Extracorporeal Life Support Organization (ELSO) dashboard. Of..

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Trends and institutional patterns of extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest in Korea: a nationwide analysis, 2016–2023

Abstract Background While the clinical effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) has gained increasing attention, its real-world utilization, patient selection, and system-level implementation remain incompletely..

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Optimizing Extracorporeal Cardiopulmonary Resuscitation Delivery for Out-of-Hospital Cardiac Arrest: A Monte Carlo Simulation Study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) can improve outcomes in refractory out-of-hospital cardiac arrest (OHCA), but access is limited by geographic and system constraints. We aimed to compare the potential..

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Venovenous extracorporeal membrane oxygenation with mechanical chest compression for cardiopulmonary resuscitation: A porcine model study

Abstract Objective To evaluate the effectiveness of venovenous (VV) extracorporeal membrane oxygenation (ECMO) using a dual-lumen cannula coupled with continuous mechanical chest compressions (cMCC) for cardiopulmonary resuscitation and compare it..

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CPR-induced consciousness in hypothermic cardiac arrest: Where is the limit of tolerance of the human brain? A case report

Abstract BackgroundCPR-induced consciousness (CPRIC) is defined as consciousness during CPR, ranging from eye opening to combative behaviour and vocalisation, despite the absence of spontaneous circulation. CPRIC has not previously been..

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Extracorporeal membrane oxygenation (ECMO): A narrative review for the emergency clinician

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) is an established therapy that supports a patient in respiratory or cardiopulmonary failure to recovery, transplant, or durable mechanical support. Prompt referral by the..

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Hypothermic Circulatory Arrest Is Associated with Increased Risk of Postoperative Delirium: A Retrospective Cohort Study

Abstract Objectives: This study aimed to measure the incidence of postoperative delirium (POD) after aortic arch surgery with hypothermic circulatory arrest (HCA), compare it to cardiac surgeries not requiring HCA, and..

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Investigating the dynamics of intracranial pressure and cerebral autoregulation during extracorporeal cardiopulmonary resuscitation using a porcine model

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising intervention for refractory cardiac arrest, with potential benefits in survival and neurological outcomes. However, the impact of ECPR’s rapid,..

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Postcardiotomy extracorporeal membrane oxygenation in patients older than 70 years: Characteristics, outcomes, and variables associated with mortality

Abstract Objectives Age is the main determinant for mortality in patients requiring postcardiotomy extracorporeal membrane oxygenation (PC-ECMO), but strategies to reverse this trend are unknown. This study investigates PC-ECMO outcomes..

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Arterial CO2 Targets in Veno-Arterial Extracorporeal Membrane Oxygenation After Cardiac Arrest

Abstract After cardiac arrest, restoration of circulation is the first step toward survivorship. Extracorporeal CPR (ECPR), the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to restore circulation, is increasingly being..

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A Dutch nationwide pediatric cardiac arrest registry with long-term follow-up – towards an international prognostication guideline

Abstract Aims Pediatric cardiac arrest is associated with high mortality and significant morbidity among survivors. International guidelines for prognostication remain limited due to small heterogeneous patient populations, variable post-return of..

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