Extracorporeal Cardiopulmonary Resuscitation in Refractory Cardiac Arrest

The benefit of Extracorporeal CardioPulmonary Resuscitation (ECPR) compared to conventional cardiopulmonary resuscitation in the management of refractory cardiac arrest remains unclear. The purpose of this systematic review is to provide an update in the field. The effect of ECPR on survival and neurological outcome in refractory out-of-hospital cardiac arrest of cardiac origin could be very limited. In contrast, ECPR could be more effective than conventional cardiopulmonary resuscitation in selected patients with in-hospital cardiac arrest of cardiac origin or that related to drug overdose. The benefit of ECPR is more contrasted in patients with refractory cardiac arrest associated with deep hypothermia following accidental exposure to cold, a drowning or an avalanche. Further studies are still needed to clarify who with refractory cardiac arrest are the most likely to benefit from ECPR.