In such cases, the ECPR provides a lifeline. This innovative treatment involves performing cardiopulmonary resuscitation (CPR) on the patient while transporting them to the hospital, where they are connected to an ECMO (extracorporeal membrane oxygenation) machine. The ECMO device traditionally used in cardiac surgical intensive care oxygenates the patient’s blood during resuscitation.
The aim of ECPR treatment is to support blood circulation during the resuscitation phase, correct the underlying cause of cardiac arrest and create conditions for the patient’s blood circulation to return. To qualify for ECPR, patients must meet certain criteria and have no significant underlying medical conditions. HUS launched its ECPR program in January 2016, in which the Department of Emergency and Prehospital Emergency Care, the Heart and Lung Center and the Department of Perioperative and Intensive Care cooperate.
In the years 2016-2021, almost three thousand resuscitation attempts were made in out-of-hospital cardiac arrest cases using mobile intensive care units staffed by HUS medical staff. Of these 73 cases, the patients were transported to Meilahti Hospital during resuscitation, when they were candidates for ECPR. Before the decision to proceed with ECPR was made, all patients received high-quality standard CPR. The average age of the study population was 54 years, and more than 90 percent were men. In most cases, the cause of cardiac arrest was either confirmed or suspected acute coronary artery disease.
The results of this study are in line with international comparisons. Patients arrived at the hospital within an average of 57 minutes of the onset of cardiac arrest and were connected to ECMO after an average of 85 minutes. ECPR treatment was administered to 37 patients, slightly more than half of those eligible. Of note, 11 of these patients (30%) recovered from cardiac arrest with a favorable neurologic outcome. In addition, eight patients regained circulation during transport to the hospital, eliminating the need for ECMO. Overall, 17 patients (23%) eligible for ECPR achieved a positive result.
ECPR patients are one of the most time-critical groups in primary care. “We have invested in training both in the field and in the hospital, which is why it is great to see how well the results are in line with international comparisons,” said the researcher and consultant physician. Tuukka Puolakka on emergency medicine and services.
Puolakka believes that this research lays the groundwork for future developments in the treatment of cardiac arrest patients. “The study shows that investing in ECPR-eligible patients is worthwhile. However, some patients were excluded from ECMO treatment and the start of treatment was sometimes delayed compared to other countries,” Puolakka pointed out.
ECPR is a relatively new treatment option worldwide, and there is still little research data on its effectiveness. “It is exceptionally encouraging to see patients recover from cardiac arrest, even with significant delays, and achieve such positive outcomes,” said Markku Kuisma, head of the first aid department of the emergency department. The findings offer hope for the future of cardiac arrest care and may pave the way for the wider adoption of ECPR as a life-saving procedure.
HT
Source: The Nordic Page