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Extrakorporale CPR (eCPR)

Seit Oktober 2015 ist die extrakorporale CPR (eCPR) Teil der ALS-Leitlinie

Extracorporeal CPR (eCPR)

Included in the ALS guidelines since October 2015

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Zusammenfassung

Hintergrund

Der plötzliche Herztod ist häufig und die Prognose selbst bei optimaler Rettungskette schlecht. Die Implantation einer miniaturisierten Herzlungenmaschine unter kardiopulmonaler Reanimation (CPR) wird als extrakorporale CPR (eCPR) bezeichnet. Seit den ab Oktober 2015 gültigen Advanced Life Support Leitlinien kann die eCPR bei ausgesuchten Patienten erwogen werden.

Zielsetzung

Vermittlung der Grundlagen der eCPR sowie Darstellung der Anforderungen an Material, Helfer und die lokalen Strukturen.

Material und Methode

Diskussion der aktuellen Literatur sowie gültiger Leitlinien.

Ergebnisse

Die eCPR kann sowohl nach innerklinischem als auch außerklinischem Herzkreislaufstillstand unter kontrollierten Bedingungen erfolgen. Ein hoher technischer und personeller Aufwand ist jedoch erforderlich. Die Implantation einer Herzlungenmaschine unter CPR dauert ca. 30 min. Eine kleine Studie mit kurzer Latenz zwischen Kollaps und eCPR berichtet ein Überleben in 54 % der Patienten. Studien mit längerer Latenz zeigen weniger positive Ergebnisse.

Schlussfolgerungen

Eine Prognoseverbesserung ausgesuchter Patienten durch die eCPR erscheint plausibel, ist aber noch nicht wissenschaftlich belegt. Ein Nutzen kann möglicherweise nur bei früher eCPR erreicht werden.

Abstract

Background

Sudden cardiac death is frequent, and prognosis of survival—even with an optimal rescue chain—is poor. Implantation of a miniaturized heart–lung machine during cardiopulmonary resuscitation (CPR) is referred to as extracorporeal CPR (eCPR). The current 2015 Advanced Life Support (ALS) guidelines advocate consideration of eCPR in selected patients.

Objectives

Discussion of eCPR basics and requirements for material, staff, and local structures.

Materials and methods

Review of current guidelines and published data.

Results

eCPR, which can be performed within a controlled environment after in-hospital and out-of-hospital cardiac arrest, is associated with high technical and personnel expenses. The implantation of a heart–lung machine during CPR takes about 30 min. A study with early eCPR after sudden cardiac death reported a 54 % patient survival. Studies with greater delay between collapse and eCPR show less favorable results.

Conclusion

An improved survival in selected patients using eCPR seems plausible, however has not been scientifically proven. A benefit in survival might be only achievable with early eCPR.

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Abbreviations

ALS:

Advanced Life Support

CPR:

Kardiopulmonale Reanimation

ECLS:

Extrakorporale Life Support

eCPR:

Extrakorporale CPR

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Authors and Affiliations

  1. Abteilung für Kardiologie und Angiologie I, Universitäts-Herzzentrum Freiburg – Bad Krozingen, Hugstetter Straße 55, 79106, Freiburg i. Br., Deutschland

    A. Supady,  T. Wengenmayer,  C. Bode &  D. L. Staudacher

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  1. A. Supady
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  2. T. Wengenmayer
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  3. C. Bode
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  4. D. L. Staudacher
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Corresponding author

Correspondence to D. L. Staudacher.

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Interessenkonflikt

A. Supady, T. Wengenmayer, C. Bode und D. L. Staudacher geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Supady, A., Wengenmayer, T., Bode, C. et al. Extrakorporale CPR (eCPR). Notfall Rettungsmed 19, 574–581 (2016). https://doi.org/10.1007/s10049-016-0166-5

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  • DOI: https://doi.org/10.1007/s10049-016-0166-5

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