Reanimationsbemühungen mit den bisher vorhandenen Möglichkeiten kommen regelmäßig
an ihre Grenzen. Die Möglichkeit zur kardiopulmonalen Unterstützung unter Einsatz
eines maschinellen extrakorporalen Kreislaufs kann für ausgewählte Patienten mit refraktärem
Herz-Kreislauf-Stillstand aufgrund potenziell reversibler Ursachen erwogen werden.
Abstract
Extracorporeal cardiopulmonary resuscitation (ECPR) to improve outcomes in out-of-hospital
cardiac arrest (OHCA) patients has gained widespread interest. Observational studies
and a randomized trial indicate better outcomes for OHCA patients who receive ECPR
over traditional resuscitation; this includes increased survival to hospital discharge
and improved neurological outcomes. However, ECPR is resource intensive and the implementation
of programs is difficult. As ECPR utilization increases, there are still relevant
uncertainties in daily practice. Hence, it is highly important that emergency physicians
are aware of the possibilities and limitations of this treatment option. This article
provides technical background as well as information regarding logistics, patient
selection and structured communication in the emergency room.
Schlüsselwörter
Reanimation - ECLS - ECMO - ECPR - OHCA
Keywords
Resuscitation - ECLS - ECMO - ECMO - OHCA