Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in Australia: a narrative review

• Published in: Medical journal of Australia Vol. 220; no. 1; pp. 46 - 53
• Main Authors: Dennis, Mark, Shekar, Kiran, Burrell, Aidan JC, Austin, Danielle, Anderson, David, Bernard, Stephen, Burns, Brian, Buscher, Hergen, Christie, Gayle, Collett, Luke, Coggins, Andrew, Doan, Tan, Dhanani, Jayesh, Finn, Judith, Fisher, Caleb, Ferguson, Ian, Forrest, Paul, Gill, Denzil, Granger, Emily, Higgins, Lisa, Hodgson, Carol, Jones, Daryl, Kruit, Natalie, La Gerche, Andre, Marasco, Silvana, Maruno, Kevin, McCanny, Peter, Moylan, Emily, Nanjayya, Vinod, Nair, Priya, Nichol, Alistair, Oliver, Matthew, Pellegrino, Vin, Plunkett, Brian, Ramanan, Mahesh, Richardson, Sacha, Southwood, Timothy J, Sackley, Mark, Semsarian, Christopher, Totaro, Richard, Winearls, James
• Format: Journal Article
• Language: English
• Published: Australia 15.01.2024
• Subjects: Extracorporeal circulation; Resuscitation; Resuscitation; Extracorporeal circulation
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/mja2.52130

Summary Extracorporeal cardiopulmonary resuscitation (ECPR) in patients with prolonged or refractory out‐of‐hospital cardiac arrest (OHCA) is likely to be beneficial when used as part of a well developed emergency service system. ECPR is technically challenging to initiate and resource‐intensive, but it has been found to be cost‐effective in hospital‐based ECPR programs. ECPR expansion within Australia has thus far been reactive and does not provide broad coverage or equity of access for patients. Newer delivery strategies that improve access to ECPR for patients with OHCA are being trialled, including networked hospital‐based ECPR and pre‐hospital ECPR programs. The efficacy, scalability, sustainability and cost‐effectiveness of these programs need to be assessed. There is a need for national collaboration to determine the most cost‐effective delivery strategies for ECPR provision along with its place in the OHCA survival chain.