Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in Australia

Written By CCRG

A narrative review

Mark Dennis, Kiran Shekar, Aidan JC Burrell Med J of Aus DOI 10.5694/mja2.52130

Summary:

  • Extracorporeal cardiopulmonary resuscitation (ECPR) in patients with prolonged or refractory out-of-hospital cardiac arrest (OHCA) is likely to be beneficial when used as part of a well developed emergency service system.

  • ECPR is technically challenging to initiate and resource-intensive, but it has been found to be cost-effective in hospital-based ECPR programs.

  • ECPR expansion within Australia has thus far been reactive and does not provide broad coverage or equity of access for patients.

  • Newer delivery strategies that improve access to ECPR for patients with OHCA are being trialled, including networked hospital-based ECPR and pre-hospital ECPR programs. The efficacy, scalability, sustainability and cost-effectiveness of these programs need to be assessed.

  • There is a need for national collaboration to determine the most cost-effective delivery strategies for ECPR provision along with its place in the OHCA survival chain.

CCRG
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