To examine the variability among ECPR protocols developed in centers across different countries and identify components that could be standardized globally and those that may need to remain context specific.
Approach:
Review Methodology: This narrative review followed the Scale for the Assessment of Narrative Review Articles (SANRA) and applied the SPIDER framework to formulate the research question regarding contemporary ECPR programs.
Key Findings:
Survival rates for cardiac arrest remain low, ranging from 8% to 34%.
ECPR has emerged as a rescue therapy for patients unresponsive to conventional CPR.
Successful ECPR depends on minimizing time to ECMO initiation and selecting appropriate patients.
ECPR protocols vary significantly across countries in logistics, team composition, cannulation methods, and monitoring.
Interpretation:
Standardization of ECPR protocols may reduce performance bias but must be approached cautiously to account for geographic and resource variability.
Limitations:
Variability in ECPR protocols may impact outcomes such as survival and neurological recovery.
The review is limited to literature published in English.
Conclusion:
The review highlights the need for a structured, multidisciplinary approach to ECPR implementation while recognizing the importance of local context.
by Samuele Bugo, Alice Bottussi, Jacopo D’Andria Ursoleo, Marta Velia Antonini, Erika Cordella, Myriam Aprile, Samuel I. Garcia, Omar Elmadhoun, Erin D. Wieruszewski, Justyna Swol, Patrick M. Wieruszewski, Fabrizio Monaco
