Hospitals slow to embrace CPR alternative

A new method to resuscitate cardiac arrest patients often proves more effective than CPR, but various implementation hurdles have prevented many hospitals from using it, according to a March 27 article in The New York Times Magazine.

In Minnesota, extracorporeal cardiopulmonary resuscitation — or ECPR — is becoming the standard of care for cardiac arrest patients. The practice entails placing patients on an extracorporeal membrane oxygenation machine, which keeps their heart and lungs working.  

Demetris Yannopoulos, MD, an interventional cardiologist and professor at the University of Minnesota Medical School in Minneapolis, started the nation's first ECPR program in 2015 after noticing improved survival rates among patients who received the intervention. The independent program consists of specialized critical care teams that serve hospitals across Minnesota. The program will often deploy mobile units to intercept ambulances so they can begin the life-saving procedure before the patient even gets to a hospital.

Many large healthcare organizations have ECMO machines, but creating a successful ECPR program is more challenging. Dr. Yannopoulos said a great deal of resources, training and coordination are required to effectively resuscitate patients with ECPR outside of hospital settings. 

"Just because you have an ECMO machine doesn't mean you have an ECPR program," Dr. Yannopoulos told The New York Times Magazine. "That's like saying I have a scalpel, and I went into the forest to cut someone's brain, so now I have a neurosurgery program."

ECPR programs for out-of-hospital cardiac arrest aren't officially monitored in the U.S., making it challenging to assess their availability, procedures and outcomes. About a dozen programs have emerged nationwide, some of which have seen modest success. Others have encountered difficulties, possibly due to limited operational hours or procedural challenges, resulting in a few programs already ending, according to the report. 

Read the full article here.

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