Patients with cardiac arrest secondary to severe environmental hypothermia (core temp ≤ 28°C) and no signs of irreversible death are candidates for V-A ECMO in the ED to facilitate rapid extracorporeal rewarming and circulatory support.
Hennepin Healthcare suspended the ECPR portion of our ECMO program in 2020 because of the COVID-19 pandemic. Data are now available from randomized clinical trials testing the effect of a system-wide ECPR strategy on neurologically favorable survival among adults with refractory out-of-hospital cardiac arrest (OHCA) and a shockable initial rhythm. We, the institutional, EMS, and ECMO leaders, interpret these data as showing that: 1) ECPR remains an experimental therapy in need of further study, and 2) available data with the highest generalizability (INCEPTION trial) does not support the effectiveness of ECPR as currently delivered. Therefore, our institution is utilizing the healthcare resources previously devoted to our ECPR program to strengthen other parts of the cardiac arrest chain of survival to offer the most benefit to the greatest number of patients with OHCA (-MP 12/6/23).
Hennepin ECMO 