Favrizio Cirillo, Department for Anaesthesiology and Intensive Care Medicine, University Hospital Cologne, Germany, and colleagues have recently published a narrative review of the literature on extracorporeal life support strategies and management for OHCA. The literature review covers 2010 until 31 May 2015, and is published in Trends in Anaesthesia & Critical Care.
The review explores and discusses:
- strategy - inclusion and exclusion criteria, location, best timing and teams and technique
- quality of resuscitation - in terms of mortality and/or neurological sequelae
They also review barriers for favourable outcome and the further use of ECLS for refractory OHCA adult patients for donation after circulatory death.
See Also: Chain of Survival after Out-of-Hospital Cardiac Arrest
Treatment of OHCA remains challenging they conclude, and patients who experience OHCA have a low probability of survival with good neurological function.
They write: “For the future, evidence-based criteria to include patients into an ECLS protocol and to estimate the success of ECLS after refractory cardiac arrest are highly desirable to avoid futile and expensive invasive manoeuvres.”