[Extracorporeal cardiopulmonary resuscitation-When the heart no longer functions].
Extrakorporale Reanimation – wenn das Herz nicht mehr funktioniert.
Extracorporeal cardiopulmonary resuscitation/complications
Extracorporeal cardiopulmonary resuscitation/ethics
Extracorporeal cardiopulmonary resuscitation/treatment outcome
Extracorporeal membrane oxygenation
Heart arrest
Journal
Innere Medizin (Heidelberg, Germany)
ISSN: 2731-7099
Titre abrégé: Inn Med (Heidelb)
Pays: Germany
ID NLM: 9918384885306676
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
accepted:
18
08
2023
medline:
23
10
2023
pubmed:
15
9
2023
entrez:
15
9
2023
Statut:
ppublish
Résumé
Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for restoring blood circulation in patients with refractory circulatory failure. While conventional resuscitation measures are being continued, venoarterial extracorporeal membrane oxygenation (VA ECMO) is established in patients with cardiac arrest. This bypass can compensate for the functions of the heart and lungs until recovery of organ function. The benefit of ECPR compared to conventional resuscitation appears to be evident, especially after a prolonged resuscitation period; however, in three prospective randomized controlled studies an advantage has not yet been conclusively proven for widespread use in clinical routine. ECPR systems are complex and resource-intensive and should therefore be limited to specialized centers where sufficient numbers of patients are treated to ensure a high level of expertise in the teams. Die extrakorporale Reanimation („extracorporeal cardiopulmonary resuscitation“ [ECPR]) ist eine Option zur Wiederherstellung des Kreislaufs bei Patienten mit refraktärem Kreislaufversagen. Unter Fortführung konventioneller Reanimationsmaßnahmen wird bei Patienten im Herz-Kreislauf-Stillstand eine venoarterielle extrakorporale Membranoxygenierung (VA ECMO) etabliert, die als Bypass die Funktionen von Herz und Lunge bis zur Erholung der Organe kompensieren kann. Im Vergleich zur konventionellen Reanimation besteht ein Vorteil für die ECPR am ehesten insbesondere nach längerer Reanimationszeit, jedoch konnte bisher in drei prospektiven randomisierten, kontrollierten Studien kein Vorteil für den allgemeinen Einsatz belegt werden. Aufbau und Betrieb eines ECPR-Systems sind komplex und ressourcenintensiv, daher sollte der Einsatz auf spezialisierte Zentren mit ausreichenden Patientenzahlen begrenzt sein, um eine hohe Expertise der Teams zu gewährleisten.
Autres résumés
Type: Publisher
(ger)
Die extrakorporale Reanimation („extracorporeal cardiopulmonary resuscitation“ [ECPR]) ist eine Option zur Wiederherstellung des Kreislaufs bei Patienten mit refraktärem Kreislaufversagen. Unter Fortführung konventioneller Reanimationsmaßnahmen wird bei Patienten im Herz-Kreislauf-Stillstand eine venoarterielle extrakorporale Membranoxygenierung (VA ECMO) etabliert, die als Bypass die Funktionen von Herz und Lunge bis zur Erholung der Organe kompensieren kann. Im Vergleich zur konventionellen Reanimation besteht ein Vorteil für die ECPR am ehesten insbesondere nach längerer Reanimationszeit, jedoch konnte bisher in drei prospektiven randomisierten, kontrollierten Studien kein Vorteil für den allgemeinen Einsatz belegt werden. Aufbau und Betrieb eines ECPR-Systems sind komplex und ressourcenintensiv, daher sollte der Einsatz auf spezialisierte Zentren mit ausreichenden Patientenzahlen begrenzt sein, um eine hohe Expertise der Teams zu gewährleisten.
Identifiants
pubmed: 37713164
doi: 10.1007/s00108-023-01587-x
pii: 10.1007/s00108-023-01587-x
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
913-921Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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