In DepthEmergency Medicine

Clinical trials test potential CPR upgrade

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Science  01 Mar 2019:
Vol. 363, Issue 6430, pp. 913-914
DOI: 10.1126/science.363.6430.913

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Summary

Only about 10% of the 350,000 or so adults in the United States struck by cardiac arrest outside a hospital each year survive. Doctors long for more ways to save them. Efforts are spreading to apply a life support system called extracorporeal cardiopulmonary resuscitation (ECPR) to these patients, and clinical trials are testing how it compares to standard CPR. The machinery for ECPR is already used to support patients in heart surgery or rescue some who suffer cardiac arrest in the hospital. It also treats infants and children teetering near death from heart and lung failure. (In pediatrics, the machinery is known as extracorporeal membrane oxygenation.) Published case reports suggest ECPR carries promise. But the technology also requires extensive training, an overhaul of paramedic practices, and tens or hundreds of thousands of dollars per patient to implement. Randomized trials will likely offer guidance as to how well ECPR works and who is most likely to be helped.

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