What is ECPR?
ECPR stands for extracorporeal cardiopulmonary resuscitation.
A cardiac arrest is an unexpected and rare event in which the heart stops effectively beating, causing blood in the body to stop flowing. It happens in ~1% of patients admitted to the cardiac ICU. This is a true medical emergency because the body requires a continuous supply of oxygen to keep cells healthy; when that does not happen, organ damage begins almost immediately. Standard treatments include CPR, placement of a breathing tube and administration of oxygen, and medications to help the heart start beating effectively again.
When these efforts are ineffective, some patients have to be rescued using a heart-lung bypass machine known as ECMO. This process of rescuing a patient whose cardiac arrest does not get better using standard techniques using ECMO is ECPR. This requires the patient’s room to be instantly transformed into an operating room. A surgical team performs emergency surgery on the blood vessels or on the heart itself to place large tubes that connect the ECMO machine to the circulation. Once turned on, the ECMO machine supplements the function of the heart and lungs, providing oxygen and warmth to the blood, and pumping it to the body.
Even with the best treatments today, fewer than 50% of patients survive an ECPR event, largely due to the oxygen deprivation that occurs during the ECPR event itself.